| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,049 |
1,047 |
$95K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,481 |
1,475 |
$68K |
| V2020 |
Frames, purchases |
1,121 |
1,118 |
$42K |
| V2025 |
Deluxe frame |
516 |
516 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,201 |
1,196 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
200 |
200 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
159 |
158 |
$12K |
| 92015 |
Determination of refractive state |
1,150 |
1,145 |
$4K |