| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,266 |
1,266 |
$132K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
348 |
348 |
$45K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,435 |
1,432 |
$44K |
| 92015 |
Determination of refractive state |
1,932 |
1,932 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,029 |
1,027 |
$24K |
| V2020 |
Frames, purchases |
1,517 |
1,515 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,500 |
1,499 |
$0.00 |