| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
48,331 |
23,296 |
$1.57M |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
49,995 |
24,079 |
$1.47M |
| V2020 |
Frames, purchases |
43,368 |
29,206 |
$863K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13,031 |
12,826 |
$589K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,674 |
6,535 |
$313K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,913 |
5,805 |
$230K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
3,199 |
1,935 |
$128K |
| 92002 |
|
3,222 |
3,163 |
$125K |
| 92015 |
Determination of refractive state |
18,018 |
17,720 |
$83K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
1,897 |
1,050 |
$62K |
| V2744 |
Tint, photochromatic, per lens |
2,013 |
1,007 |
$58K |
| V2299 |
Specialty bifocal (by report) |
1,458 |
717 |
$54K |
| V2750 |
Anti-reflective coating, per lens |
3,044 |
1,470 |
$48K |
| V2781 |
Progressive lens, per lens |
1,511 |
767 |
$47K |
| V2500 |
Contact lens, pmma, spherical, per lens |
324 |
324 |
$19K |
| V2760 |
Scratch resistant coating, per lens |
1,388 |
583 |
$12K |
| 92310 |
|
136 |
135 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
162 |
64 |
$4K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
96 |
39 |
$3K |
| V2025 |
Deluxe frame |
160 |
151 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
28 |
28 |
$840.00 |