| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
2,580 |
2,475 |
$101K |
| 92015 |
Determination of refractive state |
2,975 |
2,858 |
$67K |
| V2020 |
Frames, purchases |
763 |
742 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
74 |
70 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
300 |
296 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
50 |
49 |
$0.00 |
| V2781 |
Progressive lens, per lens |
45 |
44 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |