| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
26,677 |
14,382 |
$468K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,414 |
8,411 |
$299K |
| V2020 |
Frames, purchases |
17,027 |
16,991 |
$191K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,919 |
3,917 |
$131K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
822 |
433 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,989 |
997 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
20,624 |
10,833 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
552 |
552 |
$8K |
| 92015 |
Determination of refractive state |
846 |
846 |
$5K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
202 |
101 |
$2K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
30 |
15 |
$615.56 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$228.64 |
| V2755 |
U-v lens, per lens |
644 |
322 |
$0.00 |