| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
881 |
873 |
$39K |
| 92002 |
|
611 |
611 |
$20K |
| 92285 |
|
745 |
737 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,045 |
561 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
552 |
550 |
$16K |
| V2020 |
Frames, purchases |
1,072 |
1,050 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
138 |
81 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
43 |
43 |
$3K |
| V2199 |
Not otherwise classified, single vision lens |
502 |
251 |
$2K |
| V2299 |
Specialty bifocal (by report) |
74 |
37 |
$514.44 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
967 |
487 |
$5.00 |