| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
344 |
317 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
167 |
134 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
198 |
80 |
$6K |
| V2020 |
Frames, purchases |
134 |
108 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
150 |
119 |
$3K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
16 |
15 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
12 |
$1K |
| 92015 |
Determination of refractive state |
948 |
872 |
$257.43 |