| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,074 |
1,074 |
$105K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,387 |
1,383 |
$41K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
909 |
904 |
$21K |
| V2020 |
Frames, purchases |
1,507 |
1,503 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
82 |
82 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
93 |
93 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,527 |
1,523 |
$0.00 |