| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
2,558 |
2,484 |
$65K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,306 |
1,283 |
$42K |
| 92002 |
|
949 |
915 |
$30K |
| V2020 |
Frames, purchases |
1,278 |
1,251 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
27 |
$4K |
| 92250 |
|
28 |
28 |
$319.48 |
| 92060 |
|
15 |
15 |
$310.50 |
| V2781 |
Progressive lens, per lens |
350 |
349 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
205 |
205 |
$0.00 |
| 3072F |
|
199 |
199 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
262 |
261 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
171 |
171 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
86 |
86 |
$0.00 |
| V2199 |
Not otherwise classified, single vision lens |
26 |
13 |
$0.00 |