| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,925 |
1,794 |
$40K |
| 92002 |
|
1,122 |
1,045 |
$35K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
519 |
494 |
$17K |
| V2020 |
Frames, purchases |
757 |
745 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
220 |
198 |
$0.00 |
| V2781 |
Progressive lens, per lens |
221 |
221 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
199 |
199 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$0.00 |