| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
743 |
706 |
$84K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
731 |
690 |
$66K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
422 |
404 |
$48K |
| V2020 |
Frames, purchases |
827 |
779 |
$29K |
| V2750 |
Anti-reflective coating, per lens |
766 |
727 |
$17K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
224 |
215 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
756 |
715 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
765 |
726 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
169 |
158 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
40 |
39 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19 |
18 |
$2K |
| 92015 |
Determination of refractive state |
1,311 |
1,245 |
$490.00 |