| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,222 |
1,222 |
$122K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,608 |
1,604 |
$48K |
| 92015 |
Determination of refractive state |
1,610 |
1,604 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
981 |
975 |
$25K |
| V2020 |
Frames, purchases |
1,632 |
1,627 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
59 |
59 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$265.05 |