| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,496 |
1,422 |
$67K |
| V2020 |
Frames, purchases |
831 |
794 |
$19K |
| 92015 |
Determination of refractive state |
2,090 |
2,027 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
233 |
227 |
$6K |
| 92002 |
|
91 |
87 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
13 |
$321.40 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
75 |
60 |
$72.00 |