| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,033 |
3,932 |
$134K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
3,530 |
3,436 |
$101K |
| V2744 |
Tint, photochromatic, per lens |
3,476 |
3,378 |
$84K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
901 |
886 |
$78K |
| 92370 |
|
3,380 |
3,313 |
$59K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,594 |
2,525 |
$55K |
| V2730 |
Special base curve, glass or plastic, per lens |
3,475 |
3,379 |
$55K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
714 |
706 |
$47K |
| 92015 |
Determination of refractive state |
1,166 |
927 |
$43K |
| V2220 |
Bifocal add over 3.25d |
637 |
625 |
$41K |
| 92310 |
|
854 |
677 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
196 |
193 |
$25K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
148 |
145 |
$21K |
| 92250 |
|
334 |
329 |
$13K |
| 92341 |
|
486 |
475 |
$11K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
175 |
174 |
$8K |
| 92283 |
|
288 |
285 |
$6K |
| V2205 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
94 |
89 |
$6K |
| V2780 |
Oversize lens, per lens |
390 |
324 |
$5K |
| 92312 |
|
90 |
55 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
25 |
$3K |
| 92265 |
|
57 |
56 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$1K |
| 92326 |
|
44 |
41 |
$1K |