| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,374 |
3,374 |
$345K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
763 |
763 |
$95K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,034 |
3,029 |
$92K |
| 92015 |
Determination of refractive state |
3,945 |
3,944 |
$70K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,195 |
1,192 |
$31K |
| V2020 |
Frames, purchases |
3,012 |
3,011 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
722 |
721 |
$19K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
59 |
59 |
$4K |