| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,413 |
1,054 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,212 |
885 |
$12K |
| V2020 |
Frames, purchases |
1,519 |
1,086 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,090 |
783 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
319 |
222 |
$4K |
| V2299 |
Specialty bifocal (by report) |
75 |
53 |
$791.70 |
| V2781 |
Progressive lens, per lens |
61 |
41 |
$770.00 |
| 92015 |
Determination of refractive state |
1,221 |
898 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
770 |
557 |
$0.00 |