| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,792 |
3,426 |
$154K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,049 |
2,002 |
$50K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,011 |
976 |
$47K |
| 92002 |
|
658 |
631 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
811 |
780 |
$20K |
| 92015 |
Determination of refractive state |
857 |
795 |
$13K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
424 |
311 |
$12K |
| 92341 |
|
375 |
340 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
158 |
145 |
$3K |
| V2025 |
Deluxe frame |
123 |
122 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$502.35 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$439.13 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
15 |
$132.00 |
| 99199 |
Unlisted special service, procedure or report |
83 |
83 |
$0.00 |