| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
751 |
710 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
254 |
242 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
101 |
96 |
$7K |
| 92002 |
|
58 |
56 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
84 |
81 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$267.96 |
| 92015 |
Determination of refractive state |
525 |
524 |
$30.10 |