| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
326 |
320 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
336 |
326 |
$13K |
| V2020 |
Frames, purchases |
377 |
369 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
377 |
369 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
211 |
211 |
$4K |
| 92015 |
Determination of refractive state |
415 |
412 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
250 |
243 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
66 |
66 |
$3K |