| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
4,062 |
4,050 |
$1.20M |
| V2020 |
Frames, purchases |
8,887 |
8,835 |
$248K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,931 |
3,270 |
$111K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,320 |
1,320 |
$92K |
| V2219 |
Bifocal seg width over 28 mm |
1,129 |
1,128 |
$88K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,521 |
6,492 |
$87K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,458 |
1,456 |
$84K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,417 |
1,416 |
$81K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,443 |
3,362 |
$33K |
| 92341 |
|
1,815 |
1,814 |
$32K |
| 92015 |
Determination of refractive state |
2,460 |
2,459 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,733 |
2,635 |
$25K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,122 |
1,087 |
$22K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
895 |
832 |
$17K |
| V2199 |
Not otherwise classified, single vision lens |
1,038 |
519 |
$12K |
| V2299 |
Specialty bifocal (by report) |
258 |
129 |
$4K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
257 |
251 |
$3K |
| 92250 |
|
24 |
24 |
$1K |
| 92225 |
|
12 |
12 |
$310.50 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
26 |
25 |
$259.20 |
| V2755 |
U-v lens, per lens |
1,384 |
691 |
$0.00 |