| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,195 |
1,195 |
$112K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
643 |
643 |
$78K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,602 |
1,589 |
$48K |
| 92015 |
Determination of refractive state |
1,872 |
1,871 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,183 |
1,170 |
$31K |
| V2020 |
Frames, purchases |
1,725 |
1,699 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
242 |
237 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,690 |
1,682 |
$0.00 |