| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
255 |
157 |
$34K |
| V2020 |
Frames, purchases |
325 |
199 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
108 |
104 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
318 |
191 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
257 |
157 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
66 |
40 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
12 |
$1K |
| 92015 |
Determination of refractive state |
716 |
687 |
$570.93 |