| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
37,784 |
19,776 |
$624K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,382 |
7,071 |
$614K |
| V2020 |
Frames, purchases |
21,513 |
20,458 |
$603K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,286 |
7,054 |
$552K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
19,691 |
18,753 |
$422K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18,899 |
10,470 |
$320K |
| 92015 |
Determination of refractive state |
15,683 |
15,103 |
$172K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,814 |
2,084 |
$101K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,660 |
3,509 |
$89K |
| 92341 |
|
3,010 |
2,892 |
$77K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,424 |
934 |
$27K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
837 |
533 |
$17K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
202 |
99 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
273 |
180 |
$4K |