| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
460 |
460 |
$68K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,132 |
1,129 |
$44K |
| V2020 |
Frames, purchases |
2,129 |
2,105 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,596 |
824 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
517 |
517 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
686 |
529 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
272 |
136 |
$3K |
| 92002 |
|
136 |
135 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
37 |
28 |
$380.85 |
| 92341 |
|
14 |
14 |
$252.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
14 |
14 |
$126.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
236 |
118 |
$0.00 |