| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
554 |
554 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
881 |
880 |
$26K |
| 92002 |
|
270 |
270 |
$20K |
| 92015 |
Determination of refractive state |
1,112 |
1,112 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
503 |
503 |
$14K |
| V2020 |
Frames, purchases |
883 |
882 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$334.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
861 |
860 |
$0.00 |