| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
4,427 |
4,265 |
$336K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,528 |
5,354 |
$322K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,480 |
3,393 |
$281K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,463 |
3,434 |
$243K |
| V2760 |
Scratch resistant coating, per lens |
4,399 |
4,238 |
$137K |
| 92341 |
|
4,068 |
4,010 |
$124K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,846 |
1,833 |
$123K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,853 |
3,793 |
$120K |
| V2755 |
U-v lens, per lens |
3,913 |
3,772 |
$98K |
| 92015 |
Determination of refractive state |
3,005 |
2,956 |
$82K |
| 92250 |
|
1,607 |
1,576 |
$72K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,100 |
4,052 |
$68K |
| V2020 |
Frames, purchases |
4,168 |
4,136 |
$65K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
625 |
612 |
$46K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
502 |
480 |
$40K |
| V2744 |
Tint, photochromatic, per lens |
1,126 |
1,087 |
$27K |
| 92133 |
|
335 |
333 |
$11K |
| 92083 |
|
108 |
106 |
$6K |