| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
246 |
218 |
$14K |
| 92015 |
Determination of refractive state |
732 |
671 |
$11K |
| V2750 |
Anti-reflective coating, per lens |
307 |
273 |
$6K |
| V2020 |
Frames, purchases |
575 |
505 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
199 |
194 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
75 |
68 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
304 |
268 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
61 |
58 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
92 |
92 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
111 |
99 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
28 |
28 |
$305.00 |