| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,546 |
1,546 |
$162K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
827 |
827 |
$105K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,757 |
1,752 |
$53K |
| 92015 |
Determination of refractive state |
2,473 |
2,473 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,281 |
1,274 |
$32K |
| V2020 |
Frames, purchases |
1,808 |
1,802 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
67 |
65 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
14 |
$306.90 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,688 |
1,681 |
$13.50 |