| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,231 |
5,163 |
$337K |
| V2020 |
Frames, purchases |
8,038 |
7,873 |
$285K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,950 |
3,122 |
$103K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,187 |
2,073 |
$95K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,749 |
2,718 |
$92K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,103 |
1,071 |
$78K |
| 92341 |
|
1,545 |
1,520 |
$58K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,362 |
1,126 |
$56K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,176 |
1,061 |
$40K |
| 92015 |
Determination of refractive state |
1,306 |
1,302 |
$26K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,648 |
1,628 |
$24K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
74 |
69 |
$4K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
24 |
24 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$1K |
| V2755 |
U-v lens, per lens |
128 |
64 |
$0.00 |