| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,221 |
959 |
$241K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
785 |
715 |
$95K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,199 |
962 |
$92K |
| V2025 |
Deluxe frame |
1,144 |
925 |
$82K |
| 92060 |
|
1,444 |
1,313 |
$76K |
| V2750 |
Anti-reflective coating, per lens |
1,111 |
905 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
563 |
447 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,163 |
934 |
$29K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
252 |
230 |
$16K |
| 92202 |
|
915 |
837 |
$13K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
110 |
90 |
$7K |
| 92015 |
Determination of refractive state |
973 |
898 |
$2K |
| V2744 |
Tint, photochromatic, per lens |
55 |
51 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
12 |
$859.32 |