| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,722 |
3,722 |
$388K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,682 |
3,672 |
$112K |
| 92015 |
Determination of refractive state |
5,486 |
5,485 |
$97K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
735 |
735 |
$92K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,920 |
1,913 |
$46K |
| V2020 |
Frames, purchases |
4,351 |
4,343 |
$43K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
630 |
626 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,514 |
4,495 |
$0.00 |