| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,622 |
5,591 |
$104K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
342 |
341 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
10,241 |
5,596 |
$8K |
| V2020 |
Frames, purchases |
7,653 |
7,598 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,857 |
4,642 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
453 |
285 |
$1K |
| 92250 |
|
52 |
50 |
$640.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
26 |
$591.12 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,922 |
2,910 |
$562.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,158 |
1,156 |
$104.00 |
| V2750 |
Anti-reflective coating, per lens |
6,402 |
3,300 |
$0.00 |
| 92015 |
Determination of refractive state |
2,462 |
2,449 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
239 |
125 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
946 |
532 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
1,576 |
812 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
1,388 |
728 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,645 |
862 |
$0.00 |
| V2781 |
Progressive lens, per lens |
1,696 |
888 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
53 |
27 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
144 |
73 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
28 |
14 |
$0.00 |