| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
5,816 |
5,338 |
$307K |
| V2020 |
Frames, purchases |
2,386 |
2,112 |
$193K |
| 92015 |
Determination of refractive state |
8,527 |
7,816 |
$189K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,017 |
2,754 |
$155K |
| 92250 |
|
3,774 |
3,396 |
$121K |
| 92225 |
|
1,186 |
572 |
$23K |
| 92202 |
|
217 |
205 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
24 |
15 |
$153.54 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
76 |
76 |
$0.00 |