| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
995 |
995 |
$109K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
589 |
589 |
$77K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,162 |
2,147 |
$66K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,619 |
1,609 |
$44K |
| 92015 |
Determination of refractive state |
2,398 |
2,397 |
$42K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
299 |
298 |
$23K |
| V2020 |
Frames, purchases |
2,175 |
2,157 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
61 |
61 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,259 |
2,245 |
$0.00 |