| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
792 |
781 |
$36K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
303 |
300 |
$21K |
| V2020 |
Frames, purchases |
585 |
577 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
458 |
453 |
$6K |
| 92002 |
|
38 |
37 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
68 |
68 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$405.51 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
71 |
71 |
$0.00 |