| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,204 |
5,204 |
$542K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,302 |
5,298 |
$151K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,090 |
1,090 |
$137K |
| 92015 |
Determination of refractive state |
6,360 |
6,358 |
$113K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,351 |
3,350 |
$78K |
| V2020 |
Frames, purchases |
5,435 |
5,431 |
$54K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
668 |
668 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
487 |
487 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,333 |
4,331 |
$0.00 |