| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
7,659 |
7,445 |
$279K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,894 |
4,254 |
$250K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,023 |
4,897 |
$229K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,296 |
2,240 |
$108K |
| V2760 |
Scratch resistant coating, per lens |
7,779 |
7,564 |
$105K |
| 92015 |
Determination of refractive state |
10,517 |
9,648 |
$56K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,167 |
1,147 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
566 |
516 |
$45K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
761 |
743 |
$32K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
3,094 |
3,011 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
338 |
331 |
$13K |
| 92002 |
|
164 |
161 |
$9K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
15 |
12 |
$508.75 |
| 92250 |
|
19 |
13 |
$354.25 |