| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,890 |
1,890 |
$191K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
700 |
700 |
$86K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,596 |
2,589 |
$77K |
| 92015 |
Determination of refractive state |
3,651 |
3,651 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,481 |
1,476 |
$34K |
| V2020 |
Frames, purchases |
2,875 |
2,866 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
306 |
305 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,721 |
2,711 |
$0.00 |