| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12,721 |
3,808 |
$352K |
| V2020 |
Frames, purchases |
6,894 |
4,242 |
$299K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,329 |
5,222 |
$236K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
987 |
957 |
$45K |
| V2750 |
Anti-reflective coating, per lens |
816 |
380 |
$25K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
11,565 |
3,208 |
$20K |
| V2744 |
Tint, photochromatic, per lens |
308 |
148 |
$11K |
| V2781 |
Progressive lens, per lens |
156 |
66 |
$8K |
| V2299 |
Specialty bifocal (by report) |
156 |
66 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
119 |
119 |
$1K |
| 92015 |
Determination of refractive state |
4,206 |
4,091 |
$360.00 |