| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
761 |
761 |
$91K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
503 |
503 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,359 |
1,359 |
$40K |
| 92015 |
Determination of refractive state |
1,539 |
1,538 |
$27K |
| V2020 |
Frames, purchases |
1,369 |
1,369 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
365 |
364 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
267 |
267 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,429 |
1,428 |
$0.00 |