| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
1,137 |
1,027 |
$43K |
| 92015 |
Determination of refractive state |
1,416 |
1,306 |
$28K |
| 92283 |
|
143 |
133 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
105 |
105 |
$3K |
| V2020 |
Frames, purchases |
387 |
387 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
134 |
134 |
$0.00 |
| V2755 |
U-v lens, per lens |
46 |
46 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
173 |
173 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
184 |
184 |
$0.00 |