| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,789 |
5,222 |
$391K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,076 |
2,814 |
$305K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,114 |
1,950 |
$254K |
| 92250 |
|
3,320 |
3,212 |
$222K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,888 |
2,596 |
$206K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,970 |
2,656 |
$172K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,132 |
4,655 |
$150K |
| 92015 |
Determination of refractive state |
5,753 |
5,156 |
$92K |
| V2760 |
Scratch resistant coating, per lens |
2,467 |
2,290 |
$86K |
| V2755 |
U-v lens, per lens |
467 |
444 |
$13K |
| 92341 |
|
102 |
102 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
59 |
56 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
50 |
44 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
26 |
26 |
$1K |
| V2799 |
Vision item or service, miscellaneous |
2,201 |
2,071 |
$31.00 |