| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
9,211 |
8,815 |
$141K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,489 |
5,267 |
$131K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,644 |
3,418 |
$75K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,405 |
2,240 |
$71K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,969 |
4,771 |
$66K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,186 |
1,095 |
$29K |
| 92015 |
Determination of refractive state |
1,869 |
1,732 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
422 |
386 |
$16K |
| 92341 |
|
550 |
510 |
$13K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
421 |
396 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
324 |
312 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
217 |
209 |
$3K |
| 92283 |
|
113 |
111 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
146 |
129 |
$2K |
| 92342 |
|
36 |
36 |
$1K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
24 |
24 |
$718.16 |
| V2025 |
Deluxe frame |
15 |
15 |
$255.00 |