| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,684 |
2,627 |
$103K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,508 |
3,423 |
$76K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,161 |
2,097 |
$75K |
| V2020 |
Frames, purchases |
4,036 |
3,934 |
$55K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,779 |
2,705 |
$25K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
287 |
285 |
$10K |
| 92310 |
|
66 |
66 |
$5K |
| V2299 |
Specialty bifocal (by report) |
123 |
122 |
$4K |
| 92015 |
Determination of refractive state |
3,121 |
3,057 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
653 |
645 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
99 |
99 |
$0.00 |
| V2781 |
Progressive lens, per lens |
123 |
122 |
$0.00 |