| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
729 |
630 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,088 |
912 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
641 |
519 |
$28K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
581 |
449 |
$26K |
| 92015 |
Determination of refractive state |
1,343 |
1,139 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
284 |
219 |
$13K |
| V2025 |
Deluxe frame |
322 |
245 |
$3K |
| V2020 |
Frames, purchases |
25 |
25 |
$180.00 |