| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,844 |
1,808 |
$101K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
849 |
794 |
$37K |
| V2020 |
Frames, purchases |
705 |
657 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
261 |
258 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
850 |
792 |
$23K |
| V2750 |
Anti-reflective coating, per lens |
760 |
704 |
$15K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
53 |
35 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
39 |
37 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
27 |
$2K |
| V2755 |
U-v lens, per lens |
53 |
34 |
$2K |
| 92015 |
Determination of refractive state |
1,001 |
980 |
$61.28 |