| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
135 |
131 |
$14K |
| V2020 |
Frames, purchases |
129 |
89 |
$4K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
59 |
41 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
129 |
89 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
14 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
106 |
75 |
$1K |
| 92015 |
Determination of refractive state |
510 |
488 |
$459.70 |