| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,146 |
1,146 |
$120K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,577 |
1,576 |
$47K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
337 |
337 |
$41K |
| 92015 |
Determination of refractive state |
2,171 |
2,171 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
876 |
875 |
$21K |
| V2020 |
Frames, purchases |
1,911 |
1,910 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
240 |
240 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,939 |
1,938 |
$0.00 |