| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
547 |
473 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
242 |
215 |
$22K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
73 |
48 |
$10K |
| V2020 |
Frames, purchases |
92 |
77 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
12 |
$1K |
| V2025 |
Deluxe frame |
24 |
12 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
58 |
51 |
$934.56 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
64 |
52 |
$808.08 |
| V2750 |
Anti-reflective coating, per lens |
26 |
12 |
$338.01 |