| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18,748 |
9,277 |
$390K |
| 92002 |
|
6,394 |
6,389 |
$270K |
| V2020 |
Frames, purchases |
14,622 |
14,403 |
$260K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,375 |
5,369 |
$233K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
3,338 |
1,660 |
$97K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,641 |
1,299 |
$64K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
25,763 |
12,818 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
232 |
217 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
114 |
112 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
122 |
122 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
32 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
67 |
67 |
$970.41 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
17 |
17 |
$340.00 |
| 92015 |
Determination of refractive state |
541 |
541 |
$0.00 |