| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15,149 |
12,650 |
$714K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
10,809 |
9,412 |
$486K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
9,322 |
8,597 |
$411K |
| V2020 |
Frames, purchases |
17,110 |
14,508 |
$262K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,979 |
7,491 |
$222K |
| 92015 |
Determination of refractive state |
12,175 |
11,347 |
$175K |
| V2025 |
Deluxe frame |
4,870 |
4,514 |
$174K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,046 |
3,746 |
$171K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,220 |
1,922 |
$157K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,069 |
1,061 |
$48K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,564 |
3,339 |
$45K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,094 |
1,016 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
188 |
187 |
$9K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
344 |
310 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
421 |
410 |
$4K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
147 |
142 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
126 |
121 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
69 |
28 |
$0.00 |