| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
393 |
393 |
$41K |
| 92083 |
|
269 |
268 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
477 |
474 |
$13K |
| 92250 |
|
268 |
268 |
$13K |
| 92015 |
Determination of refractive state |
518 |
516 |
$9K |
| 92342 |
|
227 |
226 |
$8K |
| V2020 |
Frames, purchases |
484 |
481 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
122 |
121 |
$4K |
| 92275 |
|
24 |
24 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
17 |
17 |
$2K |
| 92286 |
|
15 |
15 |
$518.85 |
| 76514 |
|
19 |
19 |
$216.22 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
334 |
333 |
$0.00 |