| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,107 |
1,039 |
$45K |
| V2020 |
Frames, purchases |
1,286 |
1,205 |
$39K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,079 |
1,011 |
$31K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
445 |
432 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
355 |
348 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
671 |
629 |
$14K |
| 92015 |
Determination of refractive state |
1,232 |
1,206 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
865 |
787 |
$11K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
16 |
13 |
$928.54 |