| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,966 |
2,927 |
$73K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,634 |
1,592 |
$68K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,586 |
1,566 |
$67K |
| V2020 |
Frames, purchases |
3,815 |
3,774 |
$64K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
595 |
594 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,140 |
2,113 |
$21K |
| V2299 |
Specialty bifocal (by report) |
54 |
54 |
$2K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
29 |
29 |
$7.20 |
| 92015 |
Determination of refractive state |
2,169 |
2,145 |
$5.00 |
| V2750 |
Anti-reflective coating, per lens |
218 |
217 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
62 |
62 |
$0.00 |
| V2781 |
Progressive lens, per lens |
54 |
54 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
15 |
14 |
$0.00 |