| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,568 |
3,468 |
$92K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,536 |
1,519 |
$68K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,897 |
1,832 |
$58K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,891 |
1,872 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
726 |
724 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,081 |
1,065 |
$15K |
| 92015 |
Determination of refractive state |
383 |
380 |
$8K |
| 92060 |
|
53 |
51 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
820 |
808 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30 |
30 |
$2K |
| V2025 |
Deluxe frame |
271 |
269 |
$1K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
26 |
26 |
$410.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$132.50 |
| V2750 |
Anti-reflective coating, per lens |
29 |
29 |
$0.00 |