| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
665 |
643 |
$30K |
| 92015 |
Determination of refractive state |
1,446 |
1,418 |
$21K |
| V2020 |
Frames, purchases |
431 |
409 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
73 |
72 |
$5K |
| 92002 |
|
31 |
31 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
29 |
24 |
$518.34 |
| V2756 |
Eye glass case |
99 |
92 |
$88.03 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
17 |
13 |
$38.72 |