| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2219 |
Bifocal seg width over 28 mm |
955 |
835 |
$72K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
800 |
760 |
$48K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,416 |
2,316 |
$32K |
| V2020 |
Frames, purchases |
4,770 |
4,477 |
$32K |
| 92341 |
|
1,226 |
1,085 |
$21K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,070 |
916 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,147 |
1,023 |
$11K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
514 |
513 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
320 |
260 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
347 |
302 |
$5K |
| 92002 |
|
42 |
42 |
$2K |
| V2199 |
Not otherwise classified, single vision lens |
136 |
68 |
$1K |
| 92015 |
Determination of refractive state |
89 |
89 |
$1K |
| V2299 |
Specialty bifocal (by report) |
28 |
14 |
$809.48 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
31 |
25 |
$678.82 |
| V2755 |
U-v lens, per lens |
78 |
39 |
$0.00 |