| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
16,213 |
14,266 |
$628K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,122 |
1,092 |
$70K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
16,036 |
14,216 |
$47K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,795 |
1,505 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
642 |
627 |
$38K |
| V2500 |
Contact lens, pmma, spherical, per lens |
328 |
323 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
10,673 |
8,992 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,389 |
3,752 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,421 |
1,197 |
$4K |
| 92341 |
|
437 |
313 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
241 |
231 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
901 |
767 |
$3K |
| 92015 |
Determination of refractive state |
2,052 |
2,001 |
$475.00 |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$417.00 |
| 2022F |
|
1,112 |
1,089 |
$415.05 |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
12 |
$230.00 |
| V2799 |
Vision item or service, miscellaneous |
94 |
89 |
$0.00 |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
13 |
12 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
12 |
12 |
$0.00 |
| V2025 |
Deluxe frame |
132 |
122 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
734 |
641 |
$-203.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,710 |
2,313 |
$-268.50 |