| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,577 |
2,577 |
$270K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,598 |
1,598 |
$200K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,484 |
3,477 |
$104K |
| 92015 |
Determination of refractive state |
3,964 |
3,958 |
$69K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,686 |
1,680 |
$40K |
| V2020 |
Frames, purchases |
3,576 |
3,568 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,181 |
1,175 |
$31K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
395 |
394 |
$8K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
12 |
12 |
$279.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,495 |
3,480 |
$0.00 |
| 1036F |
|
478 |
474 |
$0.00 |