| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,086 |
2,077 |
$141K |
| V2020 |
Frames, purchases |
355 |
330 |
$56K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,014 |
1,006 |
$50K |
| 92015 |
Determination of refractive state |
3,051 |
3,026 |
$38K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
299 |
283 |
$12K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
76 |
73 |
$3K |
| 92250 |
|
62 |
62 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
15 |
14 |
$422.85 |