| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
15,178 |
11,458 |
$2.32M |
| V2025 |
Deluxe frame |
10,182 |
7,478 |
$981K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,916 |
6,748 |
$791K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,377 |
4,725 |
$609K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
11,604 |
8,872 |
$510K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
17,306 |
13,227 |
$454K |
| V2750 |
Anti-reflective coating, per lens |
17,653 |
13,344 |
$452K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
18,210 |
13,870 |
$335K |
| V2020 |
Frames, purchases |
7,659 |
6,162 |
$264K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
4,400 |
3,257 |
$213K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
515 |
300 |
$131K |
| 92015 |
Determination of refractive state |
13,846 |
11,952 |
$67K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,680 |
1,322 |
$60K |
| 92310 |
|
418 |
400 |
$47K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,108 |
1,817 |
$36K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
549 |
387 |
$31K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
101 |
100 |
$2K |