| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,194 |
1,194 |
$124K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
613 |
611 |
$75K |
| 92015 |
Determination of refractive state |
2,010 |
2,007 |
$36K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,149 |
1,144 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
772 |
771 |
$18K |
| V2020 |
Frames, purchases |
1,567 |
1,559 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
264 |
263 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,567 |
1,562 |
$0.00 |