| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
613 |
601 |
$23K |
| V2020 |
Frames, purchases |
881 |
869 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
567 |
563 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
174 |
174 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
251 |
248 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
237 |
237 |
$2K |
| 92082 |
|
13 |
13 |
$305.11 |
| 92015 |
Determination of refractive state |
1,049 |
1,037 |
$20.00 |