| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
2,100 |
2,096 |
$168K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
982 |
971 |
$76K |
| 92015 |
Determination of refractive state |
1,114 |
1,105 |
$53K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,207 |
2,206 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
970 |
500 |
$19K |
| V2020 |
Frames, purchases |
988 |
987 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
117 |
116 |
$7K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
53 |
53 |
$4K |
| 92341 |
|
27 |
27 |
$521.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,262 |
633 |
$344.00 |