| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,864 |
1,840 |
$126K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,257 |
1,236 |
$112K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,405 |
1,382 |
$91K |
| 92015 |
Determination of refractive state |
3,115 |
3,045 |
$10K |
| 92341 |
|
60 |
56 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
284 |
193 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
194 |
181 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
16 |
14 |
$0.00 |
| V2020 |
Frames, purchases |
369 |
341 |
$0.00 |