| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
3,658 |
3,476 |
$175K |
| 92250 |
|
4,136 |
3,941 |
$118K |
| 92015 |
Determination of refractive state |
5,315 |
5,041 |
$105K |
| 92083 |
|
1,911 |
1,900 |
$90K |
| V2020 |
Frames, purchases |
1,359 |
1,306 |
$88K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,596 |
1,515 |
$87K |
| 92100 |
|
773 |
765 |
$44K |
| 92081 |
|
1,153 |
990 |
$24K |
| 92202 |
|
545 |
540 |
$16K |
| 92225 |
|
125 |
125 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
65 |
62 |
$3K |
| 92226 |
|
13 |
13 |
$769.58 |
| 92285 |
|
16 |
16 |
$212.28 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
63 |
63 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
63 |
63 |
$0.00 |