| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
609 |
602 |
$25K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
235 |
227 |
$16K |
| V2020 |
Frames, purchases |
434 |
429 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
433 |
428 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
135 |
132 |
$2K |
| 92002 |
|
12 |
12 |
$825.93 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
142 |
140 |
$32.41 |