| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,846 |
1,821 |
$97K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,256 |
1,227 |
$24K |
| 92002 |
|
286 |
281 |
$14K |
| 92015 |
Determination of refractive state |
2,842 |
2,820 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
94 |
94 |
$2K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
13 |
13 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
25 |
25 |
$212.80 |
| V2750 |
Anti-reflective coating, per lens |
62 |
62 |
$0.00 |