| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,529 |
6,529 |
$704K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
8,929 |
8,921 |
$267K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,500 |
7,493 |
$209K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,598 |
1,598 |
$180K |
| 92015 |
Determination of refractive state |
8,356 |
8,352 |
$141K |
| V2020 |
Frames, purchases |
8,954 |
8,940 |
$90K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
534 |
533 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
221 |
221 |
$6K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
12 |
12 |
$334.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,657 |
8,647 |
$0.00 |