| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Frames, purchases |
18,113 |
17,871 |
$508K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
5,989 |
5,973 |
$277K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
4,707 |
4,693 |
$228K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
9,351 |
9,275 |
$178K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,271 |
2,254 |
$121K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,661 |
1,653 |
$95K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
9,327 |
8,174 |
$95K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,737 |
4,818 |
$70K |
| 92341 |
|
1,942 |
1,921 |
$42K |
| 92370 |
|
2,473 |
2,441 |
$42K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,741 |
2,338 |
$31K |
| 92015 |
Determination of refractive state |
2,599 |
2,566 |
$23K |
| 92342 |
|
643 |
638 |
$15K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,713 |
1,368 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,096 |
1,004 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,680 |
5,600 |
$12K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
471 |
405 |
$6K |
| V2744 |
Tint, photochromatic, per lens |
861 |
850 |
$4K |
| V2781 |
Progressive lens, per lens |
240 |
238 |
$3K |
| V2025 |
Deluxe frame |
165 |
162 |
$3K |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
148 |
145 |
$3K |
| 92310 |
|
26 |
26 |
$1K |
| V2755 |
U-v lens, per lens |
13 |
13 |
$0.00 |
| G8732 |
No documentation of pain assessment, reason not given |
31 |
31 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
19 |
19 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
357 |
352 |
$0.00 |
| 2022F |
|
12 |
12 |
$0.00 |