| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
1,220 |
1,054 |
$75K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
955 |
792 |
$61K |
| 92015 |
Determination of refractive state |
2,360 |
2,003 |
$48K |
| V2020 |
Frames, purchases |
337 |
298 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
28 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
61 |
31 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
31 |
31 |
$814.24 |