| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
92 |
89 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
82 |
81 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
51 |
50 |
$6K |
| V2020 |
Frames, purchases |
94 |
91 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
97 |
94 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
52 |
50 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
94 |
89 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
96 |
93 |
$1K |
| 92015 |
Determination of refractive state |
147 |
144 |
$19.40 |