| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,549 |
2,530 |
$119K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,906 |
1,894 |
$98K |
| 92015 |
Determination of refractive state |
4,626 |
4,595 |
$70K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,553 |
3,538 |
$65K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
35 |
35 |
$2K |
| V2020 |
Frames, purchases |
90 |
90 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
39 |
$497.90 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
49 |
49 |
$194.00 |