| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
678 |
641 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
684 |
658 |
$22K |
| V2020 |
Frames, purchases |
706 |
675 |
$21K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
355 |
346 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
243 |
223 |
$10K |
| 92015 |
Determination of refractive state |
790 |
787 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
389 |
370 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
367 |
347 |
$5K |