| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2750 |
Anti-reflective coating, per lens |
261 |
256 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,470 |
1,470 |
$0.00 |
| V2020 |
Frames, purchases |
1,766 |
1,760 |
$0.00 |
| 92015 |
Determination of refractive state |
29 |
29 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
15 |
15 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
941 |
932 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
334 |
333 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
687 |
677 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
99 |
99 |
$0.00 |
| V2781 |
Progressive lens, per lens |
14 |
14 |
$0.00 |