| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,291 |
2,291 |
$229K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,016 |
1,016 |
$125K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,789 |
2,766 |
$84K |
| 92015 |
Determination of refractive state |
3,029 |
3,029 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,516 |
1,508 |
$41K |
| V2020 |
Frames, purchases |
2,846 |
2,831 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
999 |
995 |
$27K |
| 92250 |
|
119 |
119 |
$4K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
61 |
61 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,909 |
2,890 |
$0.00 |