| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,028 |
2,014 |
$102K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,073 |
3,043 |
$55K |
| 92015 |
Determination of refractive state |
3,691 |
3,663 |
$50K |
| 92002 |
|
1,024 |
1,018 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
99 |
98 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
66 |
66 |
$5K |
| V2020 |
Frames, purchases |
25 |
25 |
$955.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$775.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$717.00 |