| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
643 |
575 |
$40K |
| 92015 |
Determination of refractive state |
608 |
584 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
178 |
165 |
$16K |
| V2020 |
Frames, purchases |
457 |
442 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
403 |
393 |
$12K |
| 83861 |
|
415 |
219 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
417 |
406 |
$5K |
| V2755 |
U-v lens, per lens |
172 |
169 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
12 |
$1K |
| 92002 |
|
18 |
18 |
$1K |
| 92250 |
|
14 |
13 |
$592.31 |