| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,092 |
2,046 |
$94K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,106 |
1,081 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
977 |
959 |
$37K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,122 |
1,103 |
$34K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
853 |
839 |
$28K |
| 92002 |
|
591 |
581 |
$22K |
| V2750 |
Anti-reflective coating, per lens |
780 |
565 |
$12K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
128 |
126 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,008 |
992 |
$10K |
| S0500 |
Disposable contact lens, per lens |
93 |
89 |
$8K |
| V2799 |
Vision item or service, miscellaneous |
1,180 |
1,151 |
$6K |
| V2744 |
Tint, photochromatic, per lens |
221 |
139 |
$5K |
| 92310 |
|
190 |
186 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
96 |
94 |
$4K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
115 |
114 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
93 |
93 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,574 |
1,556 |
$0.00 |
| 92250 |
|
68 |
67 |
$0.00 |
| 92015 |
Determination of refractive state |
1,861 |
1,824 |
$0.00 |