| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,595 |
1,516 |
$222K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,037 |
1,945 |
$202K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,504 |
1,416 |
$172K |
| 92250 |
|
3,485 |
3,282 |
$124K |
| V2025 |
Deluxe frame |
1,115 |
1,037 |
$119K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,065 |
1,963 |
$62K |
| V2750 |
Anti-reflective coating, per lens |
2,101 |
1,987 |
$53K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,218 |
1,157 |
$50K |
| V2020 |
Frames, purchases |
883 |
868 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,179 |
2,061 |
$37K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
193 |
188 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
79 |
75 |
$3K |
| 92015 |
Determination of refractive state |
3,985 |
3,749 |
$89.16 |