| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,824 |
2,193 |
$0.00 |
| V2020 |
Frames, purchases |
20,059 |
19,812 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
11,650 |
11,480 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
6,156 |
3,085 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
1,251 |
798 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18,465 |
10,584 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
3,866 |
1,937 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,036 |
4,270 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,077 |
1,468 |
$0.00 |
| 92002 |
|
5,449 |
5,426 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
843 |
842 |
$0.00 |
| 92250 |
|
1,758 |
1,731 |
$0.00 |
| S0500 |
Disposable contact lens, per lens |
786 |
781 |
$0.00 |
| 92310 |
|
1,031 |
1,014 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
126 |
63 |
$0.00 |
| S0581 |
Nonstandard lens (list this code in addition to the basic code for the lens) |
82 |
41 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
111 |
70 |
$0.00 |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
24 |
12 |
$0.00 |
| V2781 |
Progressive lens, per lens |
24 |
12 |
$0.00 |