| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,960 |
2,614 |
$54K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,136 |
2,896 |
$43K |
| V2020 |
Frames, purchases |
3,567 |
3,306 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,340 |
1,213 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,440 |
2,262 |
$17K |
| V2781 |
Progressive lens, per lens |
282 |
266 |
$8K |
| V2299 |
Specialty bifocal (by report) |
284 |
268 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
30 |
25 |
$565.50 |
| V2750 |
Anti-reflective coating, per lens |
1,421 |
1,315 |
$0.00 |
| 92015 |
Determination of refractive state |
2,533 |
2,225 |
$0.00 |