| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2499 |
Variable sphericity lens, other type |
1,021 |
949 |
$56K |
| V2750 |
Anti-reflective coating, per lens |
481 |
426 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
446 |
400 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
232 |
211 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
978 |
894 |
$15K |
| V2020 |
Frames, purchases |
1,034 |
961 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
562 |
510 |
$8K |
| 92015 |
Determination of refractive state |
1,115 |
1,023 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
508 |
460 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58 |
57 |
$3K |
| V2755 |
U-v lens, per lens |
467 |
448 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
137 |
130 |
$0.00 |