| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
326 |
323 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
158 |
158 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
110 |
110 |
$10K |
| V2020 |
Frames, purchases |
335 |
332 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
248 |
247 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
287 |
285 |
$6K |
| V2755 |
U-v lens, per lens |
326 |
323 |
$5K |
| 92015 |
Determination of refractive state |
350 |
347 |
$829.02 |
| V2760 |
Scratch resistant coating, per lens |
326 |
323 |
$604.11 |
| 92370 |
|
14 |
14 |
$377.00 |