| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,175 |
2,118 |
$78K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,097 |
3,026 |
$64K |
| V2020 |
Frames, purchases |
3,709 |
3,626 |
$60K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,424 |
1,402 |
$53K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,252 |
2,191 |
$22K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
208 |
203 |
$5K |
| 92015 |
Determination of refractive state |
3,705 |
3,624 |
$140.00 |
| V2760 |
Scratch resistant coating, per lens |
109 |
109 |
$0.00 |