| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
598 |
596 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
273 |
273 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
267 |
267 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
632 |
630 |
$16K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
282 |
281 |
$12K |
| V2020 |
Frames, purchases |
616 |
614 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
273 |
272 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
76 |
76 |
$1K |