| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
927 |
898 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
949 |
905 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,353 |
1,314 |
$25K |
| V2020 |
Frames, purchases |
1,621 |
1,579 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,000 |
967 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
48 |
48 |
$2K |
| V2299 |
Specialty bifocal (by report) |
12 |
12 |
$452.40 |
| V2781 |
Progressive lens, per lens |
12 |
12 |
$0.00 |
| 92015 |
Determination of refractive state |
607 |
592 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
135 |
133 |
$0.00 |