| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,409 |
2,348 |
$232K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,268 |
783 |
$98K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,822 |
1,898 |
$83K |
| V2760 |
Scratch resistant coating, per lens |
2,282 |
1,368 |
$82K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
421 |
233 |
$78K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
664 |
595 |
$66K |
| V2755 |
U-v lens, per lens |
2,045 |
1,225 |
$58K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
829 |
585 |
$49K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
234 |
223 |
$28K |
| 92015 |
Determination of refractive state |
1,756 |
1,593 |
$28K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
14 |
12 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
26 |
14 |
$1K |