| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,181 |
1,569 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
658 |
657 |
$15K |
| V2020 |
Frames, purchases |
2,336 |
2,279 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
717 |
716 |
$10K |
| V2199 |
Not otherwise classified, single vision lens |
1,972 |
985 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
149 |
76 |
$4K |
| 92015 |
Determination of refractive state |
817 |
814 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
41 |
41 |
$645.00 |
| 92002 |
|
12 |
12 |
$458.48 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
15 |
15 |
$240.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,899 |
944 |
$0.00 |
| 92310 |
|
35 |
32 |
$0.00 |