| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
693 |
693 |
$35K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
505 |
457 |
$19K |
| 92250 |
|
359 |
359 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
371 |
371 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
627 |
605 |
$12K |
| V2020 |
Frames, purchases |
717 |
717 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
422 |
403 |
$10K |
| 92015 |
Determination of refractive state |
1,024 |
1,024 |
$6K |