| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
129 |
127 |
$6K |
| 92015 |
Determination of refractive state |
292 |
288 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
217 |
212 |
$3K |
| 92002 |
|
74 |
74 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
174 |
173 |
$2K |
| V2020 |
Frames, purchases |
54 |
54 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$735.26 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
52 |
52 |
$622.00 |