| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,431 |
4,189 |
$96K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,007 |
4,835 |
$88K |
| V2020 |
Frames, purchases |
5,467 |
5,269 |
$71K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,615 |
1,511 |
$33K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,704 |
3,568 |
$27K |
| V2781 |
Progressive lens, per lens |
593 |
565 |
$21K |
| V2299 |
Specialty bifocal (by report) |
599 |
571 |
$15K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
256 |
249 |
$6K |
| V2750 |
Anti-reflective coating, per lens |
1,078 |
1,024 |
$0.00 |
| 92015 |
Determination of refractive state |
2,595 |
2,401 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
82 |
76 |
$0.00 |