| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,867 |
1,867 |
$208K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,908 |
2,886 |
$89K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,074 |
3,025 |
$85K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
562 |
562 |
$74K |
| 92015 |
Determination of refractive state |
2,746 |
2,744 |
$49K |
| V2020 |
Frames, purchases |
2,930 |
2,909 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,086 |
3,039 |
$0.00 |