| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
7,590 |
7,433 |
$340K |
| 92083 |
|
7,451 |
7,374 |
$334K |
| 92004 |
|
5,706 |
5,596 |
$294K |
| 76512 |
|
4,495 |
2,245 |
$251K |
| V2020 |
Frames, purchases |
18,007 |
17,475 |
$222K |
| 92134 |
|
7,795 |
7,723 |
$215K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13,659 |
8,889 |
$209K |
| 92250 |
|
5,057 |
5,006 |
$204K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,124 |
4,409 |
$106K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,950 |
1,880 |
$60K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,275 |
786 |
$25K |
| 92340 |
|
966 |
922 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,172 |
3,466 |
$8K |
| 99203 |
|
119 |
119 |
$8K |
| 99213 |
|
140 |
139 |
$6K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
138 |
86 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
89 |
54 |
$2K |
| 92285 |
|
46 |
45 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
28 |
26 |
$480.00 |
| 92341 |
|
24 |
24 |
$465.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
42 |
42 |
$440.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
30 |
30 |
$400.00 |
| 92133 |
|
14 |
14 |
$352.59 |
| V2755 |
U-v lens, per lens |
8,462 |
4,164 |
$12.00 |
| 2023F |
|
505 |
303 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
404 |
200 |
$0.00 |
| 2022F |
|
790 |
456 |
$0.00 |