| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,320 |
1,290 |
$35K |
| 92002 |
|
736 |
729 |
$20K |
| V2020 |
Frames, purchases |
729 |
720 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
104 |
104 |
$4K |
| V2781 |
Progressive lens, per lens |
133 |
132 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
126 |
125 |
$0.00 |
| 3072F |
|
254 |
251 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
101 |
100 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
29 |
29 |
$0.00 |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
85 |
85 |
$0.00 |