| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
118 |
118 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
71 |
69 |
$5K |
| V2020 |
Frames, purchases |
122 |
120 |
$4K |
| 92002 |
|
25 |
25 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
63 |
63 |
$709.00 |
| 92015 |
Determination of refractive state |
42 |
42 |
$697.40 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
53 |
51 |
$222.00 |
| V2756 |
Eye glass case |
125 |
123 |
$136.53 |