| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,375 |
2,202 |
$100K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,306 |
1,232 |
$81K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,225 |
2,101 |
$77K |
| V2020 |
Frames, purchases |
2,578 |
2,401 |
$22K |
| 92015 |
Determination of refractive state |
3,468 |
3,278 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,012 |
2,804 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
306 |
289 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
244 |
225 |
$6K |
| V2599 |
Contact lens, other type |
35 |
25 |
$2K |
| 92310 |
|
47 |
41 |
$200.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
406 |
378 |
$15.00 |
| V2025 |
Deluxe frame |
947 |
888 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
169 |
149 |
$0.00 |