| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
241 |
230 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
134 |
125 |
$8K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
25 |
24 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
85 |
81 |
$4K |
| V2750 |
Anti-reflective coating, per lens |
73 |
67 |
$3K |
| V2430 |
Variable asphericity lens, bifocal, full field, glass or plastic, per lens |
13 |
12 |
$3K |
| 92015 |
Determination of refractive state |
295 |
268 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$632.00 |