| 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 |
254 |
249 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
603 |
592 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
251 |
247 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
224 |
221 |
$8K |
| 92134 |
|
284 |
279 |
$5K |
| V2020 |
Frames, purchases |
476 |
463 |
$5K |
| 92015 |
Determination of refractive state |
229 |
227 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
265 |
260 |
$3K |
| V2755 |
U-v lens, per lens |
265 |
260 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
61 |
60 |
$840.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
50 |
50 |
$650.00 |