| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,142 |
1,806 |
$52K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,122 |
1,986 |
$40K |
| V2020 |
Frames, purchases |
2,563 |
2,411 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,205 |
1,003 |
$28K |
| V2781 |
Progressive lens, per lens |
279 |
257 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,485 |
1,385 |
$11K |
| V2299 |
Specialty bifocal (by report) |
280 |
258 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
82 |
80 |
$3K |
| V2744 |
Tint, photochromatic, per lens |
18 |
18 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
633 |
587 |
$0.00 |
| 92015 |
Determination of refractive state |
2,143 |
1,986 |
$0.00 |