| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
4,751 |
4,596 |
$178K |
| 92015 |
Determination of refractive state |
5,880 |
5,642 |
$149K |
| V2020 |
Frames, purchases |
3,122 |
3,027 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
202 |
199 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,582 |
1,515 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
27 |
$706.64 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
994 |
914 |
$50.00 |
| V2799 |
Vision item or service, miscellaneous |
607 |
605 |
$0.00 |
| V2755 |
U-v lens, per lens |
592 |
591 |
$0.00 |
| V2781 |
Progressive lens, per lens |
479 |
476 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
186 |
186 |
$0.00 |