| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
664 |
595 |
$75K |
| V2020 |
Frames, purchases |
1,410 |
1,313 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
501 |
474 |
$53K |
| V2755 |
U-v lens, per lens |
2,024 |
1,889 |
$47K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
617 |
589 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
105 |
104 |
$12K |
| 92015 |
Determination of refractive state |
894 |
858 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
27 |
$2K |