| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
2,929 |
2,471 |
$121K |
| 92015 |
Determination of refractive state |
3,849 |
3,160 |
$70K |
| V2020 |
Frames, purchases |
478 |
448 |
$44K |
| 92250 |
|
1,078 |
751 |
$31K |
| 92285 |
|
899 |
582 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
95 |
95 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
111 |
97 |
$2K |
| V2799 |
Vision item or service, miscellaneous |
24 |
15 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
87 |
69 |
$688.53 |
| V2755 |
U-v lens, per lens |
115 |
95 |
$8.93 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$0.00 |
| V2702 |
Deluxe lens feature |
17 |
17 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
93 |
81 |
$0.00 |