| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,612 |
4,463 |
$134K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,317 |
1,295 |
$113K |
| V2020 |
Frames, purchases |
3,612 |
3,516 |
$102K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,455 |
4,329 |
$96K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,046 |
1,032 |
$81K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,103 |
2,568 |
$67K |
| V2025 |
Deluxe frame |
634 |
623 |
$43K |
| 92015 |
Determination of refractive state |
3,670 |
3,592 |
$40K |
| 92341 |
|
389 |
383 |
$12K |
| 92250 |
|
470 |
464 |
$11K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
44 |
36 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
26 |
$748.75 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
14 |
14 |
$0.00 |