| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
758 |
758 |
$36K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,210 |
1,207 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
405 |
405 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,057 |
1,056 |
$14K |
| V2020 |
Frames, purchases |
1,403 |
1,402 |
$14K |
| 92015 |
Determination of refractive state |
1,349 |
1,349 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,403 |
1,402 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
218 |
218 |
$3K |