| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,721 |
2,607 |
$1.19M |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,699 |
1,592 |
$96K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,432 |
1,366 |
$75K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,437 |
2,300 |
$67K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,363 |
1,301 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
756 |
717 |
$46K |
| 92015 |
Determination of refractive state |
1,797 |
1,697 |
$16K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
66 |
49 |
$3K |
| 92341 |
|
84 |
78 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
499 |
446 |
$401.82 |
| V2025 |
Deluxe frame |
57 |
37 |
$307.59 |
| 92342 |
|
79 |
78 |
$0.00 |
| V2756 |
Eye glass case |
79 |
78 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
46 |
42 |
$0.00 |
| 3072F |
|
37 |
33 |
$0.00 |
| 2022F |
|
72 |
70 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
106 |
106 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
48 |
46 |
$0.00 |