| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
75 |
66 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
26 |
25 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
75 |
67 |
$2K |
| V2020 |
Frames, purchases |
57 |
50 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
77 |
67 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
78 |
68 |
$1K |
| 92015 |
Determination of refractive state |
277 |
264 |
$68.70 |