| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,721 |
2,344 |
$154K |
| V2020 |
Frames, purchases |
2,988 |
2,490 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,110 |
1,098 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
769 |
763 |
$31K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
676 |
625 |
$26K |
| 92002 |
|
397 |
358 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,300 |
1,434 |
$3K |
| V2299 |
Specialty bifocal (by report) |
28 |
14 |
$1K |
| 92250 |
|
12 |
12 |
$638.04 |
| V2750 |
Anti-reflective coating, per lens |
835 |
405 |
$69.00 |
| V2744 |
Tint, photochromatic, per lens |
126 |
60 |
$0.00 |
| V2781 |
Progressive lens, per lens |
28 |
14 |
$0.00 |