| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,685 |
2,308 |
$77K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,013 |
912 |
$73K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,002 |
962 |
$68K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,732 |
1,523 |
$53K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,681 |
2,309 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
49 |
45 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
24 |
$1K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
24 |
24 |
$883.20 |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
13 |
13 |
$665.86 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
12 |
$602.88 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
414 |
331 |
$198.16 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
277 |
228 |
$1.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
16 |
16 |
$0.00 |