| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,819 |
1,676 |
$138K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,388 |
1,300 |
$137K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,168 |
1,953 |
$61K |
| V2020 |
Frames, purchases |
2,317 |
2,093 |
$54K |
| 92015 |
Determination of refractive state |
3,255 |
2,984 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,195 |
1,979 |
$42K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
13 |
$878.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
30 |
29 |
$340.86 |