| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
13,236 |
11,966 |
$361K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12,118 |
11,300 |
$334K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,850 |
7,067 |
$135K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
10,308 |
9,257 |
$77K |
| 92370 |
|
1,829 |
1,699 |
$47K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,243 |
2,053 |
$33K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,750 |
1,603 |
$29K |
| V2760 |
Scratch resistant coating, per lens |
10,053 |
9,016 |
$18K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
233 |
211 |
$11K |
| V2781 |
Progressive lens, per lens |
249 |
236 |
$9K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
308 |
285 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
83 |
82 |
$2K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
44 |
42 |
$748.80 |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$213.25 |
| 92015 |
Determination of refractive state |
94 |
94 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
70 |
63 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
28 |
$0.00 |