| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,816 |
2,816 |
$300K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,485 |
3,467 |
$106K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
816 |
816 |
$103K |
| 92015 |
Determination of refractive state |
3,748 |
3,747 |
$66K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,487 |
1,480 |
$40K |
| V2020 |
Frames, purchases |
3,569 |
3,551 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,081 |
1,074 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,625 |
3,606 |
$0.00 |