| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,191 |
5,147 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,912 |
1,909 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,535 |
1,435 |
$31K |
| V2199 |
Not otherwise classified, single vision lens |
2,808 |
1,403 |
$29K |
| V2299 |
Specialty bifocal (by report) |
1,056 |
527 |
$14K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
726 |
443 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
810 |
807 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,175 |
597 |
$7K |
| 92002 |
|
99 |
99 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
420 |
210 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
77 |
77 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
97 |
97 |
$2K |
| 92341 |
|
37 |
37 |
$648.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
68 |
68 |
$603.00 |
| 92015 |
Determination of refractive state |
56 |
56 |
$324.00 |
| V2760 |
Scratch resistant coating, per lens |
356 |
178 |
$20.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,775 |
2,860 |
$10.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
36 |
18 |
$10.00 |
| V2755 |
U-v lens, per lens |
2,696 |
1,344 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
138 |
114 |
$0.00 |