| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
672 |
615 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
413 |
397 |
$27K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
330 |
189 |
$14K |
| V2020 |
Frames, purchases |
1,450 |
1,177 |
$10K |
| 92015 |
Determination of refractive state |
1,899 |
1,594 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,332 |
1,082 |
$5K |
| 92002 |
|
64 |
55 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,574 |
1,236 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
60 |
55 |
$10.00 |
| V2025 |
Deluxe frame |
40 |
29 |
$0.00 |