| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
13,365 |
12,565 |
$175K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,865 |
7,495 |
$152K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
10,208 |
9,601 |
$129K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,149 |
1,976 |
$98K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,665 |
2,411 |
$66K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,844 |
1,711 |
$44K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,411 |
1,348 |
$39K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,254 |
5,895 |
$31K |
| 92002 |
|
1,435 |
1,343 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
297 |
256 |
$7K |
| 92015 |
Determination of refractive state |
6,064 |
5,628 |
$5K |
| V2781 |
Progressive lens, per lens |
85 |
81 |
$2K |
| V2299 |
Specialty bifocal (by report) |
92 |
85 |
$2K |
| 92310 |
|
52 |
50 |
$2K |
| 92342 |
|
31 |
30 |
$994.54 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
50 |
48 |
$502.72 |
| V2744 |
Tint, photochromatic, per lens |
239 |
229 |
$0.00 |
| 3072F |
|
40 |
40 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
1,289 |
1,221 |
$0.00 |
| 2024F |
|
142 |
137 |
$0.00 |