| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
160 |
160 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
87 |
87 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
60 |
60 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$0.00 |
| V2020 |
Frames, purchases |
121 |
121 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
33 |
33 |
$0.00 |