| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
2,062 |
1,811 |
$44K |
| 92002 |
|
927 |
807 |
$36K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
706 |
632 |
$22K |
| V2020 |
Frames, purchases |
257 |
252 |
$3K |
| V2025 |
Deluxe frame |
97 |
97 |
$0.00 |
| V2221 |
Lenticular lens, per lens, bifocal |
25 |
25 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
12 |
12 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
202 |
199 |
$0.00 |
| V2755 |
U-v lens, per lens |
145 |
145 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
15 |
15 |
$0.00 |