| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,022 |
4,022 |
$443K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,342 |
3,342 |
$438K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,972 |
6,963 |
$212K |
| 92015 |
Determination of refractive state |
8,026 |
8,026 |
$143K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,864 |
4,856 |
$119K |
| V2020 |
Frames, purchases |
7,020 |
7,009 |
$70K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,656 |
1,650 |
$37K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
486 |
486 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
122 |
122 |
$9K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
26 |
26 |
$613.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,133 |
7,120 |
$0.00 |