| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,403 |
1,401 |
$110K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,877 |
1,858 |
$56K |
| 92015 |
Determination of refractive state |
2,041 |
2,039 |
$36K |
| 92002 |
|
453 |
453 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,028 |
1,017 |
$26K |
| V2020 |
Frames, purchases |
1,837 |
1,820 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
591 |
583 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
38 |
38 |
$802.48 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,880 |
1,859 |
$0.00 |