| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,168 |
3,702 |
$167K |
| 92015 |
Determination of refractive state |
6,680 |
6,017 |
$155K |
| V2020 |
Frames, purchases |
3,062 |
2,911 |
$41K |
| 92002 |
|
1,074 |
1,018 |
$30K |
| 92100 |
|
936 |
893 |
$16K |
| 92250 |
|
418 |
411 |
$11K |
| 92283 |
|
818 |
793 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
362 |
359 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
459 |
423 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
254 |
247 |
$2K |
| V2781 |
Progressive lens, per lens |
547 |
542 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
854 |
844 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
203 |
202 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
762 |
756 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$0.00 |