| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,068 |
1,068 |
$114K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,237 |
1,229 |
$38K |
| 92015 |
Determination of refractive state |
1,373 |
1,373 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
139 |
139 |
$18K |
| V2020 |
Frames, purchases |
1,129 |
1,122 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
371 |
368 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
148 |
146 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,225 |
1,216 |
$0.00 |