| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
684 |
684 |
$74K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,145 |
1,142 |
$34K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
236 |
236 |
$29K |
| 92015 |
Determination of refractive state |
1,285 |
1,285 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
696 |
694 |
$18K |
| V2020 |
Frames, purchases |
1,218 |
1,216 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
314 |
314 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
910 |
907 |
$0.00 |