| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,732 |
2,732 |
$278K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
905 |
905 |
$110K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,231 |
3,230 |
$97K |
| 92015 |
Determination of refractive state |
3,778 |
3,777 |
$66K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,112 |
2,111 |
$58K |
| V2020 |
Frames, purchases |
3,238 |
3,237 |
$32K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$334.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,261 |
3,260 |
$0.00 |