| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,111 |
3,055 |
$233K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,168 |
1,163 |
$209K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,492 |
1,484 |
$171K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,420 |
1,385 |
$151K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,468 |
1,460 |
$124K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,696 |
1,681 |
$98K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,681 |
2,653 |
$87K |
| V2760 |
Scratch resistant coating, per lens |
1,649 |
1,641 |
$64K |
| 92015 |
Determination of refractive state |
2,296 |
2,281 |
$41K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
247 |
241 |
$13K |
| 92285 |
|
275 |
273 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
39 |
39 |
$2K |
| 92370 |
|
12 |
12 |
$319.99 |