| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,561 |
2,446 |
$112K |
| V2020 |
Frames, purchases |
3,809 |
3,776 |
$54K |
| 92002 |
|
1,319 |
1,316 |
$50K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,309 |
1,406 |
$49K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,358 |
791 |
$36K |
| 92250 |
|
850 |
848 |
$34K |
| V2199 |
Not otherwise classified, single vision lens |
2,142 |
1,067 |
$26K |
| V2299 |
Specialty bifocal (by report) |
552 |
275 |
$10K |
| 92285 |
|
255 |
255 |
$7K |
| 92082 |
|
99 |
99 |
$4K |
| 92202 |
|
157 |
129 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,748 |
1,432 |
$948.00 |
| 92083 |
|
15 |
15 |
$705.00 |
| V2760 |
Scratch resistant coating, per lens |
200 |
100 |
$140.00 |
| 92015 |
Determination of refractive state |
47 |
47 |
$37.24 |
| V2750 |
Anti-reflective coating, per lens |
429 |
215 |
$2.00 |
| V2755 |
U-v lens, per lens |
2,106 |
1,050 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
30 |
15 |
$0.00 |