| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,715 |
3,715 |
$378K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,643 |
1,643 |
$202K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,268 |
5,253 |
$157K |
| 92015 |
Determination of refractive state |
6,967 |
6,966 |
$121K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,989 |
2,982 |
$67K |
| V2020 |
Frames, purchases |
5,585 |
5,566 |
$54K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
541 |
540 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
37 |
37 |
$683.55 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,432 |
5,414 |
$0.00 |