| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
983 |
920 |
$31K |
| V2020 |
Frames, purchases |
980 |
904 |
$31K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
349 |
331 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
782 |
730 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
255 |
237 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
196 |
174 |
$5K |
| 92002 |
|
25 |
25 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
51 |
50 |
$0.00 |