| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
117 |
101 |
$9K |
| 92060 |
|
187 |
177 |
$9K |
| V2020 |
Frames, purchases |
114 |
88 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
84 |
73 |
$5K |
| 92015 |
Determination of refractive state |
341 |
301 |
$5K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
19 |
19 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$690.68 |
| 92341 |
|
18 |
18 |
$666.36 |