| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,448 |
2,448 |
$225K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
927 |
927 |
$91K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,866 |
2,814 |
$85K |
| 92015 |
Determination of refractive state |
3,502 |
3,494 |
$61K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,725 |
1,691 |
$40K |
| V2020 |
Frames, purchases |
2,877 |
2,824 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,019 |
1,005 |
$23K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
121 |
121 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,009 |
2,953 |
$0.00 |