| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
136 |
136 |
$8.54 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
693 |
688 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
453 |
444 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
424 |
423 |
$0.00 |
| 92015 |
Determination of refractive state |
1,520 |
1,511 |
$0.00 |
| V2020 |
Frames, purchases |
1,460 |
1,455 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,800 |
1,776 |
$0.00 |
| 2022F |
|
76 |
69 |
$0.00 |