| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
2,429 |
1,307 |
$364K |
| V2020 |
Frames, purchases |
3,120 |
1,695 |
$121K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,000 |
1,631 |
$53K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,184 |
641 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
354 |
353 |
$42K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
867 |
481 |
$18K |
| V2755 |
U-v lens, per lens |
219 |
150 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
66 |
39 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
50 |
27 |
$2K |
| V2780 |
Oversize lens, per lens |
59 |
43 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$207.20 |
| V2744 |
Tint, photochromatic, per lens |
17 |
14 |
$185.98 |