| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
70 |
69 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
37 |
37 |
$3K |
| 92015 |
Determination of refractive state |
266 |
263 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
96 |
95 |
$1K |
| V2020 |
Frames, purchases |
158 |
157 |
$661.14 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
149 |
147 |
$425.40 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
143 |
83 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
20 |
20 |
$0.00 |