| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,778 |
1,778 |
$185K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,246 |
3,226 |
$97K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
882 |
882 |
$92K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,502 |
2,485 |
$68K |
| 92015 |
Determination of refractive state |
2,824 |
2,823 |
$42K |
| V2020 |
Frames, purchases |
3,226 |
3,203 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
534 |
533 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,131 |
3,110 |
$0.00 |