| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
980 |
974 |
$41K |
| V2020 |
Frames, purchases |
1,259 |
1,243 |
$38K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,109 |
1,094 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
675 |
670 |
$28K |
| 92015 |
Determination of refractive state |
1,464 |
1,451 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
333 |
331 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
699 |
699 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
858 |
845 |
$11K |
| 92341 |
|
13 |
13 |
$365.82 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$323.18 |