| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
348 |
335 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
696 |
659 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
669 |
627 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
206 |
187 |
$16K |
| V2020 |
Frames, purchases |
974 |
869 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
314 |
304 |
$5K |
| 92015 |
Determination of refractive state |
28 |
28 |
$398.44 |