| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,785 |
3,405 |
$201K |
| V2020 |
Frames, purchases |
4,809 |
4,753 |
$187K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,039 |
1,027 |
$63K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,803 |
2,767 |
$42K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
484 |
477 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
733 |
730 |
$35K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
919 |
911 |
$18K |
| 92341 |
|
885 |
872 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
393 |
201 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,374 |
1,479 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
57 |
57 |
$2K |
| 92371 |
|
198 |
194 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
28 |
28 |
$1K |
| 92015 |
Determination of refractive state |
155 |
154 |
$919.16 |