| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
338 |
300 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
152 |
136 |
$13K |
| V2020 |
Frames, purchases |
394 |
344 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
107 |
82 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
428 |
216 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
266 |
234 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
101 |
46 |
$743.05 |