| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,617 |
1,973 |
$50K |
| V2020 |
Frames, purchases |
3,529 |
3,441 |
$50K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
848 |
809 |
$38K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
665 |
653 |
$34K |
| 92002 |
|
506 |
500 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
449 |
436 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,058 |
528 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,403 |
1,386 |
$21K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,270 |
1,255 |
$16K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
68 |
63 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
55 |
53 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
49 |
49 |
$2K |
| 92015 |
Determination of refractive state |
2,266 |
2,103 |
$2K |
| 92341 |
|
58 |
57 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,375 |
1,673 |
$223.00 |