| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
1,605 |
1,554 |
$66K |
| 92015 |
Determination of refractive state |
2,929 |
2,835 |
$64K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,116 |
1,084 |
$48K |
| 92250 |
|
1,801 |
1,758 |
$37K |
| V2020 |
Frames, purchases |
938 |
910 |
$19K |
| 92134 |
|
26 |
26 |
$29.18 |
| V2744 |
Tint, photochromatic, per lens |
39 |
39 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
193 |
192 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
52 |
44 |
$0.00 |