| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,575 |
2,229 |
$147K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
84 |
84 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
90 |
90 |
$3K |
| V2020 |
Frames, purchases |
89 |
89 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
114 |
102 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
55 |
55 |
$432.00 |
| 92310 |
|
26 |
13 |
$413.00 |
| 92250 |
|
14 |
13 |
$149.01 |