| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,209 |
1,208 |
$92K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,445 |
2,435 |
$74K |
| 92015 |
Determination of refractive state |
2,853 |
2,852 |
$51K |
| 92002 |
|
426 |
426 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,233 |
1,227 |
$30K |
| V2020 |
Frames, purchases |
2,431 |
2,423 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
158 |
158 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
338 |
337 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
57 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$918.49 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
26 |
26 |
$613.80 |