| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,105 |
2,089 |
$76K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,518 |
1,515 |
$59K |
| V2020 |
Frames, purchases |
2,079 |
2,075 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,679 |
1,675 |
$33K |
| 92015 |
Determination of refractive state |
3,516 |
3,491 |
$27K |
| 92250 |
|
547 |
544 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
315 |
314 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
177 |
175 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
43 |
43 |
$689.22 |