| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
501 |
486 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
375 |
363 |
$36K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
307 |
292 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
184 |
172 |
$5K |
| V2020 |
Frames, purchases |
270 |
256 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
43 |
42 |
$653.25 |
| 92250 |
|
12 |
12 |
$354.87 |