| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
13,441 |
12,211 |
$211K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,662 |
6,072 |
$156K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,046 |
4,435 |
$86K |
| V2781 |
Progressive lens, per lens |
191 |
154 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
985 |
979 |
$13K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
691 |
650 |
$13K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
404 |
373 |
$9K |
| V2025 |
Deluxe frame |
143 |
109 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
725 |
659 |
$8K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
67 |
66 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
25 |
24 |
$1K |
| 92341 |
|
21 |
20 |
$247.20 |
| 92015 |
Determination of refractive state |
30 |
30 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
28 |
12 |
$0.00 |