| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
680 |
676 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,145 |
1,128 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
201 |
199 |
$14K |
| V2025 |
Deluxe frame |
485 |
482 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
155 |
155 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
88 |
88 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
68 |
68 |
$6K |
| V2020 |
Frames, purchases |
248 |
246 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$3K |
| 92015 |
Determination of refractive state |
728 |
723 |
$3K |