| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,159 |
1,125 |
$44K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,237 |
1,718 |
$25K |
| 92015 |
Determination of refractive state |
1,896 |
1,849 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
279 |
274 |
$10K |
| V2020 |
Frames, purchases |
1,642 |
1,623 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,596 |
1,578 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,103 |
1,089 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
199 |
196 |
$0.00 |