| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,804 |
1,803 |
$198K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
802 |
802 |
$104K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,440 |
2,437 |
$73K |
| 92015 |
Determination of refractive state |
3,236 |
3,231 |
$57K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,230 |
1,215 |
$29K |
| V2020 |
Frames, purchases |
2,457 |
2,451 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
187 |
185 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
52 |
52 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,809 |
1,805 |
$0.00 |