| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
253 |
242 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
172 |
167 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
170 |
158 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
160 |
151 |
$4K |
| V2020 |
Frames, purchases |
177 |
165 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
72 |
68 |
$2K |
| 92015 |
Determination of refractive state |
356 |
345 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
82 |
81 |
$1K |