| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,988 |
4,094 |
$284K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,012 |
2,973 |
$134K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
1,578 |
1,407 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
898 |
894 |
$51K |
| V2020 |
Frames, purchases |
5,210 |
4,332 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,479 |
1,151 |
$45K |
| V2202 |
Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens |
630 |
539 |
$31K |
| 92015 |
Determination of refractive state |
4,080 |
4,031 |
$21K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
556 |
421 |
$20K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
313 |
291 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
73 |
60 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
85 |
65 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
49 |
38 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
33 |
27 |
$1K |
| 92134 |
|
29 |
27 |
$857.22 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
19 |
12 |
$570.00 |
| 92310 |
|
106 |
105 |
$0.00 |