| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
7,640 |
7,432 |
$292K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,739 |
4,634 |
$240K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,242 |
6,104 |
$192K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,662 |
2,613 |
$137K |
| 92015 |
Determination of refractive state |
4,403 |
4,309 |
$89K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,257 |
1,221 |
$69K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,424 |
2,401 |
$56K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
761 |
761 |
$29K |
| 92341 |
|
561 |
544 |
$13K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
203 |
203 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
216 |
216 |
$3K |
| 92250 |
|
32 |
32 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
38 |
38 |
$363.66 |
| V2744 |
Tint, photochromatic, per lens |
14 |
14 |
$31.16 |
| V2750 |
Anti-reflective coating, per lens |
14 |
14 |
$0.00 |
| V2025 |
Deluxe frame |
691 |
690 |
$0.00 |