| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,677 |
1,448 |
$44K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
805 |
714 |
$14K |
| V2020 |
Frames, purchases |
992 |
887 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
233 |
216 |
$7K |
| V2781 |
Progressive lens, per lens |
94 |
75 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
646 |
572 |
$3K |
| V2299 |
Specialty bifocal (by report) |
94 |
75 |
$2K |
| 92310 |
|
28 |
25 |
$792.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
19 |
18 |
$490.10 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$248.80 |
| V2750 |
Anti-reflective coating, per lens |
315 |
268 |
$0.00 |
| 92015 |
Determination of refractive state |
954 |
831 |
$0.00 |