| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,067 |
4,067 |
$435K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,872 |
1,872 |
$240K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,732 |
4,727 |
$144K |
| 92015 |
Determination of refractive state |
5,659 |
5,659 |
$100K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,421 |
2,416 |
$58K |
| V2020 |
Frames, purchases |
4,783 |
4,779 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
603 |
602 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$279.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,096 |
4,094 |
$0.00 |