| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
628 |
628 |
$20K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
343 |
296 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
406 |
406 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
76 |
76 |
$5K |
| 92015 |
Determination of refractive state |
421 |
420 |
$5K |
| 92250 |
|
182 |
181 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$1K |
| 92082 |
|
24 |
24 |
$651.36 |