| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,166 |
2,157 |
$128K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,010 |
1,002 |
$68K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,663 |
2,649 |
$48K |
| 92015 |
Determination of refractive state |
3,351 |
3,335 |
$43K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,035 |
1,031 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,156 |
1,155 |
$8K |
| V2020 |
Frames, purchases |
748 |
748 |
$8K |
| V2760 |
Scratch resistant coating, per lens |
194 |
194 |
$2K |