| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,879 |
1,599 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,555 |
1,448 |
$22K |
| V2020 |
Frames, purchases |
1,779 |
1,661 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,232 |
1,147 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
309 |
267 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
40 |
38 |
$1K |
| 92015 |
Determination of refractive state |
1,327 |
1,219 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
430 |
405 |
$0.00 |