| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
509 |
492 |
$27K |
| 92015 |
Determination of refractive state |
921 |
886 |
$10K |
| V2020 |
Frames, purchases |
222 |
212 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
164 |
155 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
14 |
$923.51 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
43 |
40 |
$780.00 |