| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
507 |
495 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
677 |
234 |
$18K |
| V2020 |
Frames, purchases |
408 |
270 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
230 |
230 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
445 |
131 |
$923.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$120.00 |