| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
147 |
147 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
211 |
209 |
$6K |
| 92015 |
Determination of refractive state |
218 |
218 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
86 |
86 |
$2K |
| V2020 |
Frames, purchases |
212 |
210 |
$2K |
| 92002 |
|
30 |
30 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
75 |
74 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
199 |
198 |
$0.00 |