| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,338 |
5,192 |
$96K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,670 |
3,500 |
$81K |
| V2020 |
Frames, purchases |
5,751 |
5,597 |
$77K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,292 |
2,206 |
$50K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,489 |
4,359 |
$37K |
| V2781 |
Progressive lens, per lens |
419 |
400 |
$15K |
| V2299 |
Specialty bifocal (by report) |
443 |
423 |
$11K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
45 |
38 |
$829.40 |
| V2744 |
Tint, photochromatic, per lens |
62 |
58 |
$0.00 |
| V2755 |
U-v lens, per lens |
14 |
14 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
1,575 |
1,475 |
$0.00 |
| 92015 |
Determination of refractive state |
1,829 |
1,728 |
$0.00 |