| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
596 |
589 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
462 |
459 |
$13K |
| V2744 |
Tint, photochromatic, per lens |
41 |
41 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
113 |
113 |
$0.00 |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
157 |
156 |
$0.00 |
| V2020 |
Frames, purchases |
448 |
443 |
$0.00 |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
15 |
15 |
$0.00 |