| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
480 |
463 |
$57K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
194 |
127 |
$41K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
295 |
201 |
$25K |
| 92250 |
|
567 |
546 |
$22K |
| V2020 |
Frames, purchases |
268 |
186 |
$18K |
| V2750 |
Anti-reflective coating, per lens |
278 |
189 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
297 |
201 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
41 |
27 |
$3K |
| V2755 |
U-v lens, per lens |
72 |
71 |
$2K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
73 |
72 |
$1K |
| 92015 |
Determination of refractive state |
554 |
536 |
$10.25 |