| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,449 |
2,449 |
$183K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,104 |
1,104 |
$83K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,691 |
2,681 |
$82K |
| 92015 |
Determination of refractive state |
3,834 |
3,825 |
$68K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,722 |
1,716 |
$44K |
| V2020 |
Frames, purchases |
3,115 |
3,109 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,163 |
1,161 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,166 |
3,156 |
$0.00 |