| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
3,069 |
2,941 |
$80K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,137 |
1,124 |
$37K |
| 92002 |
|
835 |
801 |
$29K |
| 92250 |
|
331 |
180 |
$7K |
| V2020 |
Frames, purchases |
1,431 |
1,415 |
$6K |
| 92100 |
|
147 |
100 |
$4K |
| 92060 |
|
131 |
85 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
590 |
589 |
$3K |
| V2199 |
Not otherwise classified, single vision lens |
37 |
37 |
$896.78 |
| V2744 |
Tint, photochromatic, per lens |
731 |
728 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
45 |
44 |
$0.00 |
| V2781 |
Progressive lens, per lens |
181 |
181 |
$0.00 |
| V2755 |
U-v lens, per lens |
81 |
79 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
940 |
937 |
$0.00 |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
180 |
180 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
88 |
88 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
50 |
49 |
$0.00 |