| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,732 |
1,660 |
$43K |
| 92002 |
|
555 |
548 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
605 |
576 |
$16K |
| V2020 |
Frames, purchases |
524 |
514 |
$6K |
| 92225 |
|
24 |
12 |
$595.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
15 |
$0.01 |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
136 |
68 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
14 |
14 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
109 |
109 |
$0.00 |
| V2781 |
Progressive lens, per lens |
55 |
55 |
$0.00 |
| 3072F |
|
99 |
99 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$0.00 |