| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
623 |
573 |
$26K |
| V2020 |
Frames, purchases |
670 |
608 |
$23K |
| 92015 |
Determination of refractive state |
993 |
909 |
$5K |
| 92002 |
|
95 |
93 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
116 |
85 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
81 |
56 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
90 |
79 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
141 |
89 |
$890.00 |