| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
655 |
651 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,236 |
1,202 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
185 |
185 |
$7K |
| 92015 |
Determination of refractive state |
1,015 |
1,011 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
928 |
913 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,246 |
1,222 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
84 |
83 |
$0.00 |
| V2020 |
Frames, purchases |
1,220 |
1,195 |
$0.00 |