| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,565 |
1,565 |
$170K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,011 |
3,010 |
$91K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,074 |
3,047 |
$85K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
546 |
546 |
$71K |
| 92015 |
Determination of refractive state |
3,138 |
3,135 |
$56K |
| V2020 |
Frames, purchases |
3,039 |
3,035 |
$30K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
204 |
204 |
$15K |
| 92370 |
|
244 |
233 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,435 |
2,410 |
$0.00 |