| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
4,407 |
4,338 |
$932K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,051 |
4,037 |
$475K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,440 |
2,433 |
$359K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,154 |
4,098 |
$342K |
| V2020 |
Frames, purchases |
4,472 |
4,430 |
$332K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,435 |
4,393 |
$147K |
| 92015 |
Determination of refractive state |
6,611 |
6,583 |
$124K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,254 |
2,250 |
$118K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,471 |
1,464 |
$71K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
614 |
589 |
$32K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
531 |
529 |
$28K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
96 |
94 |
$8K |
| V2780 |
Oversize lens, per lens |
58 |
58 |
$0.00 |