| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
2,939 |
1,862 |
$511K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,649 |
1,525 |
$188K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,039 |
1,924 |
$159K |
| V2020 |
Frames, purchases |
3,063 |
1,940 |
$152K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,943 |
1,209 |
$102K |
| V2750 |
Anti-reflective coating, per lens |
3,037 |
1,922 |
$86K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
673 |
631 |
$69K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,061 |
1,934 |
$65K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
158 |
97 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
59 |
39 |
$3K |
| 92015 |
Determination of refractive state |
2,632 |
2,405 |
$1K |
| 92250 |
|
22 |
14 |
$552.72 |
| V2744 |
Tint, photochromatic, per lens |
18 |
13 |
$509.66 |