| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,032 |
1,017 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,308 |
573 |
$36K |
| V2020 |
Frames, purchases |
819 |
713 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
117 |
117 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,028 |
432 |
$3K |
| 92250 |
|
43 |
41 |
$2K |
| 92015 |
Determination of refractive state |
143 |
136 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
14 |
14 |
$140.00 |