| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
513 |
482 |
$15K |
| V2020 |
Frames, purchases |
247 |
240 |
$7K |
| 92015 |
Determination of refractive state |
259 |
251 |
$2K |
| 92341 |
|
28 |
26 |
$390.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
133 |
110 |
$237.42 |
| V2215 |
Lenticular (myodisc), per lens, bifocal |
13 |
13 |
$151.34 |
| V2755 |
U-v lens, per lens |
24 |
24 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$0.00 |