| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
498 |
496 |
$21K |
| V2020 |
Frames, purchases |
421 |
419 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
83 |
83 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
342 |
340 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
41 |
41 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
64 |
64 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$792.94 |