| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,748 |
4,674 |
$289K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,218 |
2,191 |
$164K |
| V2020 |
Frames, purchases |
1,748 |
1,672 |
$73K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,857 |
897 |
$62K |
| 92015 |
Determination of refractive state |
7,170 |
7,049 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,733 |
4,690 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
346 |
184 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
23 |
12 |
$594.83 |