| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
9,886 |
9,867 |
$133K |
| V2219 |
Bifocal seg width over 28 mm |
1,181 |
1,180 |
$89K |
| 92002 |
|
1,931 |
1,931 |
$74K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
3,831 |
3,827 |
$65K |
| V2020 |
Frames, purchases |
7,371 |
7,357 |
$48K |
| 92341 |
|
2,708 |
2,705 |
$47K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
944 |
943 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,580 |
2,577 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,107 |
1,983 |
$21K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
942 |
941 |
$19K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
800 |
726 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
799 |
799 |
$8K |
| 92015 |
Determination of refractive state |
560 |
560 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
258 |
205 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
64 |
64 |
$4K |
| V2199 |
Not otherwise classified, single vision lens |
152 |
76 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
30 |
30 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
106 |
106 |
$1K |
| V2755 |
U-v lens, per lens |
250 |
125 |
$0.00 |