| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
10,619 |
10,475 |
$404K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,150 |
4,073 |
$314K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,412 |
7,302 |
$290K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13,260 |
13,136 |
$242K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,101 |
3,069 |
$170K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,402 |
2,337 |
$157K |
| 92341 |
|
4,104 |
4,027 |
$93K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,618 |
3,563 |
$88K |
| 92015 |
Determination of refractive state |
8,199 |
8,048 |
$85K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
990 |
978 |
$75K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
630 |
605 |
$28K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
462 |
454 |
$12K |
| 92370 |
|
266 |
259 |
$5K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
116 |
115 |
$3K |
| 92250 |
|
30 |
30 |
$768.82 |