| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17,649 |
8,920 |
$347K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,330 |
5,321 |
$196K |
| V2020 |
Frames, purchases |
11,211 |
10,952 |
$134K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,904 |
1,494 |
$79K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,978 |
1,969 |
$77K |
| 92250 |
|
759 |
759 |
$17K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
244 |
244 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,468 |
4,097 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
405 |
405 |
$5K |
| 92310 |
|
13 |
13 |
$0.00 |
| 92225 |
|
132 |
132 |
$0.00 |
| 92201 |
|
33 |
32 |
$0.00 |