| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
514 |
344 |
$62K |
| V2025 |
Deluxe frame |
285 |
187 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
203 |
175 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
129 |
122 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
520 |
358 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
474 |
327 |
$9K |
| V2020 |
Frames, purchases |
154 |
122 |
$5K |
| V2750 |
Anti-reflective coating, per lens |
321 |
209 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
47 |
26 |
$2K |
| 92015 |
Determination of refractive state |
42 |
42 |
$0.00 |