| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,318 |
1,050 |
$131K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
607 |
438 |
$51K |
| V2020 |
Frames, purchases |
1,297 |
1,002 |
$26K |
| 92015 |
Determination of refractive state |
2,089 |
1,644 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,426 |
1,120 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
900 |
697 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$0.00 |