| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,283 |
3,241 |
$76K |
| V2020 |
Frames, purchases |
4,008 |
3,953 |
$66K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,023 |
1,014 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
782 |
776 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,066 |
3,025 |
$26K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
199 |
199 |
$7K |
| V2299 |
Specialty bifocal (by report) |
53 |
51 |
$2K |
| 92015 |
Determination of refractive state |
2,007 |
1,989 |
$791.54 |
| V2744 |
Tint, photochromatic, per lens |
165 |
164 |
$80.00 |
| V2750 |
Anti-reflective coating, per lens |
431 |
428 |
$0.00 |
| V2781 |
Progressive lens, per lens |
53 |
51 |
$0.00 |