| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,010 |
791 |
$186K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
947 |
750 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
483 |
463 |
$57K |
| V2020 |
Frames, purchases |
993 |
793 |
$53K |
| V2755 |
U-v lens, per lens |
969 |
769 |
$31K |
| V2750 |
Anti-reflective coating, per lens |
994 |
793 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
225 |
219 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
969 |
773 |
$22K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
123 |
121 |
$18K |
| 92015 |
Determination of refractive state |
31 |
28 |
$0.00 |