| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,104 |
1,104 |
$116K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,701 |
1,697 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
304 |
304 |
$38K |
| 92015 |
Determination of refractive state |
1,765 |
1,763 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
840 |
837 |
$23K |
| V2020 |
Frames, purchases |
1,771 |
1,769 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
44 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
130 |
130 |
$0.00 |