| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,145 |
5,145 |
$546K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,858 |
5,852 |
$177K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,024 |
6,015 |
$167K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,230 |
1,230 |
$157K |
| 92015 |
Determination of refractive state |
7,107 |
7,106 |
$125K |
| V2020 |
Frames, purchases |
5,765 |
5,759 |
$57K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
44 |
44 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
79 |
79 |
$0.00 |