| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18,890 |
6,283 |
$515K |
| V2020 |
Frames, purchases |
10,187 |
7,015 |
$424K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,535 |
6,369 |
$285K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,328 |
4,235 |
$187K |
| V2750 |
Anti-reflective coating, per lens |
3,323 |
1,432 |
$93K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14,611 |
4,475 |
$15K |
| V2781 |
Progressive lens, per lens |
250 |
125 |
$13K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
140 |
137 |
$12K |
| V2744 |
Tint, photochromatic, per lens |
333 |
163 |
$11K |
| V2299 |
Specialty bifocal (by report) |
246 |
122 |
$9K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
261 |
117 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
139 |
71 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
393 |
384 |
$4K |
| 92015 |
Determination of refractive state |
975 |
968 |
$3K |
| S0500 |
Disposable contact lens, per lens |
29 |
29 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
21 |
20 |
$630.00 |
| 2023F |
|
25 |
25 |
$0.00 |