| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
2,574 |
1,884 |
$371K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,474 |
4,689 |
$269K |
| V2020 |
Frames, purchases |
6,456 |
4,685 |
$251K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,731 |
1,578 |
$204K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,787 |
1,637 |
$179K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,310 |
2,467 |
$170K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,070 |
4,386 |
$121K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,037 |
1,038 |
$73K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,076 |
562 |
$27K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
281 |
236 |
$17K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
118 |
66 |
$4K |
| 92015 |
Determination of refractive state |
246 |
192 |
$3K |
| 92341 |
|
87 |
61 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
26 |
13 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
41 |
14 |
$647.46 |