| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
339 |
339 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
441 |
420 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
126 |
126 |
$6K |
| V2020 |
Frames, purchases |
279 |
271 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
341 |
322 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13 |
13 |
$228.00 |