| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,560 |
2,560 |
$271K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,421 |
3,410 |
$103K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,420 |
3,402 |
$94K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
581 |
580 |
$69K |
| 92015 |
Determination of refractive state |
3,251 |
3,250 |
$57K |
| V2020 |
Frames, purchases |
3,414 |
3,404 |
$34K |
| 92370 |
|
327 |
314 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
50 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,010 |
2,005 |
$0.00 |