| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,045 |
915 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
862 |
812 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,027 |
916 |
$29K |
| 92015 |
Determination of refractive state |
1,095 |
1,004 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
330 |
298 |
$15K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
83 |
62 |
$12K |
| V2025 |
Deluxe frame |
758 |
649 |
$12K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
221 |
188 |
$10K |
| V2020 |
Frames, purchases |
273 |
246 |
$7K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
158 |
155 |
$7K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
86 |
83 |
$4K |
| S0581 |
Nonstandard lens (list this code in addition to the basic code for the lens) |
31 |
31 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
130 |
100 |
$0.00 |