| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,896 |
2,896 |
$302K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,504 |
1,504 |
$191K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,820 |
2,815 |
$86K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,014 |
3,012 |
$84K |
| 92015 |
Determination of refractive state |
3,519 |
3,517 |
$63K |
| V2020 |
Frames, purchases |
3,353 |
3,337 |
$34K |
| 92250 |
|
367 |
367 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
28 |
26 |
$2K |
| 92083 |
|
43 |
43 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,050 |
3,048 |
$0.00 |