| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
440 |
371 |
$28K |
| 92015 |
Determination of refractive state |
678 |
597 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
90 |
85 |
$10K |
| V2020 |
Frames, purchases |
63 |
39 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
63 |
39 |
$913.77 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$506.74 |