| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
906 |
906 |
$95K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,326 |
1,318 |
$40K |
| 92015 |
Determination of refractive state |
1,542 |
1,542 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
192 |
192 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
738 |
736 |
$17K |
| V2020 |
Frames, purchases |
1,412 |
1,408 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
125 |
125 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,382 |
1,378 |
$0.00 |