| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
611 |
611 |
$27K |
| 92250 |
|
356 |
356 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
587 |
587 |
$16K |
| V2020 |
Frames, purchases |
770 |
770 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
544 |
480 |
$8K |
| 92015 |
Determination of refractive state |
960 |
959 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
296 |
206 |
$5K |
| 92081 |
|
127 |
127 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
42 |
42 |
$897.00 |