| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,545 |
5,294 |
$156K |
| 92015 |
Determination of refractive state |
4,259 |
4,067 |
$154K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,425 |
5,209 |
$112K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,695 |
1,628 |
$110K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,243 |
2,127 |
$109K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,675 |
2,578 |
$75K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,359 |
1,309 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,239 |
1,187 |
$39K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
342 |
335 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
140 |
140 |
$4K |
| 92250 |
|
25 |
25 |
$1K |