| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
628 |
583 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
147 |
131 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
165 |
158 |
$7K |
| 92002 |
|
75 |
75 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$1K |
| V2020 |
Frames, purchases |
26 |
26 |
$731.50 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$245.01 |
| 99072 |
|
90 |
75 |
$0.00 |