| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
259 |
253 |
$6K |
| V2020 |
Frames, purchases |
353 |
342 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
32 |
32 |
$2K |
| 92002 |
|
46 |
46 |
$673.38 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
57 |
56 |
$321.19 |
| 92015 |
Determination of refractive state |
27 |
27 |
$0.00 |