| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
885 |
873 |
$38K |
| 92002 |
|
665 |
657 |
$28K |
| V2020 |
Frames, purchases |
1,562 |
1,535 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
917 |
907 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
624 |
617 |
$7K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
134 |
134 |
$4K |
| 92015 |
Determination of refractive state |
1,595 |
1,575 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
39 |
39 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$298.56 |
| 92250 |
|
38 |
38 |
$0.00 |