| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
435 |
432 |
$25K |
| V2020 |
Frames, purchases |
464 |
461 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
134 |
133 |
$13K |
| 92341 |
|
322 |
321 |
$9K |
| 92015 |
Determination of refractive state |
464 |
460 |
$6K |
| 92250 |
|
364 |
360 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
125 |
124 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
17 |
17 |
$1K |