| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,101 |
1,062 |
$75K |
| V2020 |
Frames, purchases |
1,577 |
1,508 |
$72K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
754 |
738 |
$43K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
743 |
723 |
$42K |
| V2760 |
Scratch resistant coating, per lens |
1,448 |
1,389 |
$30K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
145 |
136 |
$13K |
| 92015 |
Determination of refractive state |
1,894 |
1,814 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
109 |
96 |
$4K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
332 |
314 |
$3K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
27 |
27 |
$329.00 |