| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
361 |
357 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
261 |
260 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
277 |
276 |
$7K |
| V2020 |
Frames, purchases |
339 |
338 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
260 |
256 |
$6K |
| 92082 |
|
56 |
56 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
119 |
119 |
$1K |
| 92015 |
Determination of refractive state |
441 |
439 |
$40.00 |
| 3072F |
|
12 |
12 |
$0.00 |