| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,968 |
2,901 |
$105K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,728 |
3,641 |
$94K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,061 |
3,945 |
$88K |
| V2020 |
Frames, purchases |
4,290 |
4,184 |
$81K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,590 |
1,561 |
$61K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
363 |
351 |
$11K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
84 |
84 |
$2K |
| 92015 |
Determination of refractive state |
3,702 |
3,615 |
$187.47 |
| V2750 |
Anti-reflective coating, per lens |
246 |
227 |
$0.00 |