| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,096 |
2,067 |
$278K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
521 |
516 |
$84K |
| 92202 |
|
1,766 |
1,272 |
$30K |
| 92226 |
|
648 |
539 |
$24K |
| 92225 |
|
482 |
395 |
$19K |
| V2020 |
Frames, purchases |
629 |
494 |
$10K |
| 68761 |
|
25 |
24 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
57 |
57 |
$2K |
| 92250 |
|
24 |
24 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17 |
17 |
$425.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
31 |
31 |
$0.00 |