| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
385 |
352 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
487 |
455 |
$14K |
| 92015 |
Determination of refractive state |
451 |
418 |
$5K |
| V2020 |
Frames, purchases |
447 |
416 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
280 |
266 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
127 |
119 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
385 |
353 |
$4K |
| V2755 |
U-v lens, per lens |
385 |
353 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
111 |
105 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
322 |
296 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
15 |
15 |
$450.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
33 |
33 |
$448.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
32 |
30 |
$434.00 |
| 92341 |
|
13 |
13 |
$346.61 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$261.03 |
| 92225 |
|
16 |
13 |
$80.36 |