| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,535 |
4,422 |
$94K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,455 |
2,392 |
$89K |
| V2020 |
Frames, purchases |
4,930 |
4,814 |
$66K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,698 |
1,651 |
$60K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,134 |
4,027 |
$35K |
| 92310 |
|
95 |
95 |
$7K |
| V2299 |
Specialty bifocal (by report) |
39 |
39 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
49 |
49 |
$1K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
78 |
78 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
269 |
260 |
$0.00 |
| V2781 |
Progressive lens, per lens |
39 |
39 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
1,183 |
1,164 |
$0.00 |
| 92015 |
Determination of refractive state |
180 |
168 |
$0.00 |