| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
202 |
202 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
656 |
656 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
114 |
114 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
450 |
450 |
$5K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
111 |
111 |
$2K |
| 65778 |
|
64 |
64 |
$134.12 |