| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,971 |
5,971 |
$579K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,872 |
1,872 |
$229K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,949 |
6,943 |
$201K |
| 92015 |
Determination of refractive state |
8,878 |
8,876 |
$141K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,449 |
3,447 |
$84K |
| V2020 |
Frames, purchases |
6,875 |
6,868 |
$67K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
459 |
459 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,243 |
7,237 |
$0.00 |