| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,014 |
1,014 |
$100K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,556 |
1,549 |
$46K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,488 |
1,482 |
$42K |
| 92015 |
Determination of refractive state |
1,568 |
1,568 |
$28K |
| V2020 |
Frames, purchases |
1,563 |
1,556 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
41 |
41 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
17 |
17 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,488 |
1,482 |
$0.00 |