| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,788 |
5,040 |
$146K |
| V2020 |
Frames, purchases |
8,380 |
7,521 |
$127K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,265 |
4,680 |
$104K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,101 |
2,720 |
$73K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,241 |
4,649 |
$61K |
| V2781 |
Progressive lens, per lens |
1,217 |
1,112 |
$50K |
| V2299 |
Specialty bifocal (by report) |
1,219 |
1,114 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,473 |
1,340 |
$28K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
297 |
272 |
$9K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
77 |
62 |
$2K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
75 |
75 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
29 |
29 |
$597.12 |
| 92015 |
Determination of refractive state |
7,234 |
6,444 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
2,457 |
2,187 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
442 |
413 |
$0.00 |