| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,318 |
1,311 |
$78K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
488 |
488 |
$30K |
| V2020 |
Frames, purchases |
1,503 |
1,502 |
$29K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
659 |
659 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
268 |
268 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
228 |
228 |
$5K |
| 92015 |
Determination of refractive state |
1,752 |
1,748 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
580 |
579 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
30 |
30 |
$2K |
| V2744 |
Tint, photochromatic, per lens |
13 |
13 |
$0.00 |