| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
202 |
192 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
99 |
95 |
$4K |
| V2020 |
Frames, purchases |
199 |
185 |
$3K |
| 92015 |
Determination of refractive state |
315 |
299 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
175 |
155 |
$2K |
| 92353 |
|
29 |
28 |
$582.38 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
108 |
96 |
$565.64 |