| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
224 |
224 |
$11K |
| V2020 |
Frames, purchases |
447 |
442 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
388 |
328 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
409 |
408 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
119 |
116 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
51 |
51 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
15 |
15 |
$736.95 |
| V2025 |
Deluxe frame |
16 |
16 |
$316.80 |