| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,291 |
1,273 |
$56K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,082 |
1,060 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,545 |
1,349 |
$46K |
| V2020 |
Frames, purchases |
1,807 |
1,782 |
$20K |
| 92015 |
Determination of refractive state |
670 |
666 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,226 |
1,193 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
85 |
85 |
$1K |
| 2023F |
|
12 |
12 |
$0.00 |
| V2755 |
U-v lens, per lens |
64 |
32 |
$0.00 |