| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,581 |
2,343 |
$36K |
| V2020 |
Frames, purchases |
3,856 |
2,557 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,105 |
836 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,114 |
735 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,634 |
1,951 |
$10K |
| V2781 |
Progressive lens, per lens |
59 |
56 |
$2K |
| V2299 |
Specialty bifocal (by report) |
59 |
56 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
43 |
36 |
$678.60 |
| V2744 |
Tint, photochromatic, per lens |
14 |
14 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
591 |
485 |
$0.00 |
| 92015 |
Determination of refractive state |
918 |
741 |
$0.00 |