| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
1,552 |
1,547 |
$463K |
| V2020 |
Frames, purchases |
4,085 |
4,074 |
$72K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,735 |
3,727 |
$50K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,062 |
2,061 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,270 |
1,268 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
806 |
801 |
$12K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
716 |
714 |
$8K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
119 |
119 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
358 |
356 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
27 |
27 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$201.60 |