| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
3,074 |
2,916 |
$74K |
| 92002 |
|
1,941 |
1,917 |
$56K |
| V2020 |
Frames, purchases |
1,287 |
1,195 |
$21K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
372 |
365 |
$11K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
572 |
569 |
$0.00 |
| V2781 |
Progressive lens, per lens |
278 |
277 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
379 |
283 |
$0.00 |
| V2755 |
U-v lens, per lens |
155 |
155 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
262 |
262 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
312 |
228 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
15 |
$0.00 |