| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
317 |
282 |
$21K |
| 92015 |
Determination of refractive state |
561 |
522 |
$19K |
| V2020 |
Frames, purchases |
131 |
127 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
21 |
21 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
49 |
46 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
127 |
123 |
$1K |