| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
15,196 |
15,012 |
$279K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,091 |
7,062 |
$253K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,360 |
5,089 |
$154K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,435 |
5,127 |
$153K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,843 |
1,840 |
$66K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,890 |
1,379 |
$52K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,782 |
1,205 |
$49K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
743 |
736 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
215 |
162 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,997 |
1,134 |
$5K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
149 |
94 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
29 |
28 |
$435.00 |
| 92015 |
Determination of refractive state |
272 |
270 |
$399.00 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
12 |
12 |
$280.00 |
| V2755 |
U-v lens, per lens |
24 |
12 |
$0.00 |