| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,592 |
1,592 |
$168K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,169 |
1,169 |
$149K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,651 |
1,643 |
$50K |
| 92015 |
Determination of refractive state |
1,988 |
1,983 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,180 |
1,173 |
$32K |
| V2020 |
Frames, purchases |
1,649 |
1,639 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$334.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,672 |
1,659 |
$0.00 |