| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,993 |
1,974 |
$93K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,684 |
1,423 |
$68K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
260 |
259 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,317 |
1,305 |
$12K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
105 |
100 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
146 |
146 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
168 |
84 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,164 |
646 |
$3K |
| 92341 |
|
81 |
78 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
113 |
113 |
$2K |
| 92015 |
Determination of refractive state |
137 |
137 |
$851.18 |