| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
279 |
279 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
637 |
633 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
652 |
651 |
$18K |
| 92015 |
Determination of refractive state |
813 |
813 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
52 |
52 |
$7K |
| V2020 |
Frames, purchases |
644 |
640 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
650 |
649 |
$0.00 |