| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
2,131 |
1,832 |
$96K |
| 92015 |
Determination of refractive state |
3,294 |
2,842 |
$73K |
| V2020 |
Frames, purchases |
749 |
696 |
$47K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
396 |
320 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
104 |
49 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
52 |
49 |
$272.68 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
44 |
44 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
65 |
56 |
$0.00 |