| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
34,615 |
34,329 |
$1.53M |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
20,367 |
20,261 |
$1.25M |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
9,047 |
8,960 |
$793K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,129 |
6,129 |
$718K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,016 |
6,015 |
$588K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,884 |
4,864 |
$332K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,996 |
2,987 |
$207K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
7,064 |
7,047 |
$176K |
| 92015 |
Determination of refractive state |
6,067 |
6,066 |
$92K |
| 92341 |
|
4,338 |
4,334 |
$87K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,898 |
3,884 |
$58K |
| 92370 |
|
1,208 |
1,195 |
$8K |