| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,341 |
2,338 |
$247K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,719 |
2,707 |
$81K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
628 |
628 |
$78K |
| 92015 |
Determination of refractive state |
3,419 |
3,415 |
$60K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,533 |
1,524 |
$36K |
| V2020 |
Frames, purchases |
2,902 |
2,888 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
962 |
956 |
$23K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
41 |
40 |
$906.75 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,139 |
3,122 |
$50.00 |