| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,114 |
2,108 |
$163K |
| 92015 |
Determination of refractive state |
4,792 |
4,771 |
$85K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,481 |
2,463 |
$75K |
| 92002 |
|
1,008 |
1,007 |
$73K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
432 |
432 |
$46K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,686 |
1,673 |
$42K |
| V2020 |
Frames, purchases |
2,451 |
2,438 |
$25K |
| 92065 |
|
330 |
121 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
450 |
446 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
90 |
90 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
101 |
99 |
$6K |
| 92060 |
|
106 |
97 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
17 |
17 |
$390.60 |
| V2715 |
Prism, per lens |
12 |
12 |
$185.61 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,443 |
2,425 |
$0.00 |