| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,269 |
2,228 |
$103K |
| V2020 |
Frames, purchases |
2,633 |
2,410 |
$77K |
| 92002 |
|
1,017 |
999 |
$51K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,313 |
1,294 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
486 |
449 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
938 |
867 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
281 |
269 |
$4K |
| 92341 |
|
130 |
127 |
$4K |
| 92015 |
Determination of refractive state |
141 |
125 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
671 |
653 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
33 |
24 |
$340.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$125.76 |
| 99199 |
Unlisted special service, procedure or report |
13 |
12 |
$0.00 |