| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,131 |
1,131 |
$123K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,537 |
1,528 |
$46K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,520 |
1,520 |
$42K |
| 92015 |
Determination of refractive state |
1,768 |
1,767 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
205 |
205 |
$26K |
| V2020 |
Frames, purchases |
1,785 |
1,784 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
92 |
91 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
695 |
694 |
$0.00 |