| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
388 |
371 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
631 |
611 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
498 |
486 |
$15K |
| V2020 |
Frames, purchases |
718 |
688 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
99 |
99 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
191 |
183 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
34 |
26 |
$555.75 |