| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,283 |
2,104 |
$142K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,745 |
1,901 |
$65K |
| V2020 |
Frames, purchases |
3,147 |
2,896 |
$59K |
| 92015 |
Determination of refractive state |
2,950 |
2,736 |
$46K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,021 |
1,842 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
144 |
144 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
815 |
481 |
$13K |
| 92002 |
|
105 |
95 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
30 |
30 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
86 |
45 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
47 |
28 |
$1K |