| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
324 |
298 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
339 |
324 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
250 |
231 |
$5K |
| V2020 |
Frames, purchases |
393 |
372 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
330 |
310 |
$3K |
| V2781 |
Progressive lens, per lens |
13 |
13 |
$550.00 |
| V2299 |
Specialty bifocal (by report) |
14 |
14 |
$452.40 |
| 92015 |
Determination of refractive state |
141 |
127 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
73 |
63 |
$0.00 |