| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,399 |
1,353 |
$81K |
| V2020 |
Frames, purchases |
1,624 |
1,494 |
$37K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
431 |
425 |
$31K |
| 92002 |
|
465 |
448 |
$29K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
882 |
786 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
201 |
189 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
41 |
41 |
$4K |
| 92015 |
Determination of refractive state |
2,705 |
2,617 |
$933.10 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
267 |
254 |
$875.16 |
| V2756 |
Eye glass case |
680 |
658 |
$683.64 |