| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
8,048 |
8,026 |
$280K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13,618 |
13,584 |
$192K |
| V2020 |
Frames, purchases |
18,002 |
17,976 |
$177K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12,173 |
12,144 |
$152K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,878 |
2,874 |
$116K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,185 |
2,181 |
$41K |
| 92341 |
|
2,246 |
2,240 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,567 |
2,564 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,868 |
2,863 |
$23K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
335 |
335 |
$13K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
542 |
541 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
109 |
109 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
525 |
524 |
$4K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
347 |
345 |
$4K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
99 |
98 |
$1K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
38 |
38 |
$697.50 |
| 92015 |
Determination of refractive state |
156 |
153 |
$360.00 |
| V2025 |
Deluxe frame |
185 |
185 |
$0.00 |