| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
610 |
546 |
$98K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
604 |
535 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
489 |
435 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
413 |
390 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
640 |
562 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
54 |
54 |
$2K |
| 92015 |
Determination of refractive state |
710 |
680 |
$2K |
| G8397 |
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
223 |
215 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
502 |
439 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
175 |
174 |
$0.00 |
| 92025 |
|
21 |
21 |
$0.00 |