| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,005 |
3,983 |
$27K |
| V2020 |
Frames, purchases |
3,027 |
2,983 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,094 |
2,682 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
359 |
359 |
$2K |
| 92015 |
Determination of refractive state |
2,703 |
2,687 |
$378.40 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$231.60 |
| V2750 |
Anti-reflective coating, per lens |
2,350 |
1,161 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,797 |
1,913 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
104 |
52 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
58 |
29 |
$0.00 |
| 2023F |
|
155 |
155 |
$0.00 |