| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,150 |
1,090 |
$50K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
515 |
504 |
$40K |
| V2020 |
Frames, purchases |
899 |
880 |
$25K |
| V2430 |
Variable asphericity lens, bifocal, full field, glass or plastic, per lens |
14 |
14 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$900.00 |
| 92015 |
Determination of refractive state |
95 |
92 |
$896.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$340.34 |
| 3072F |
|
162 |
157 |
$140.00 |