| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
396 |
386 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
460 |
457 |
$8K |
| V2020 |
Frames, purchases |
507 |
498 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
260 |
245 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
396 |
389 |
$2K |
| V2781 |
Progressive lens, per lens |
12 |
12 |
$220.00 |
| V2299 |
Specialty bifocal (by report) |
12 |
12 |
$150.80 |
| 92015 |
Determination of refractive state |
180 |
172 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
91 |
85 |
$0.00 |