| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,904 |
1,845 |
$97K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,169 |
2,109 |
$84K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,644 |
1,592 |
$65K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,301 |
3,158 |
$63K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,344 |
2,629 |
$44K |
| V2020 |
Frames, purchases |
4,132 |
3,267 |
$40K |
| 92015 |
Determination of refractive state |
3,287 |
3,164 |
$38K |
| V2760 |
Scratch resistant coating, per lens |
1,895 |
1,832 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,120 |
3,239 |
$14K |
| V2755 |
U-v lens, per lens |
1,910 |
1,848 |
$11K |
| 92250 |
|
112 |
101 |
$3K |
| 92341 |
|
63 |
55 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
18 |
12 |
$300.00 |