| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
568 |
562 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
254 |
252 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
208 |
203 |
$23K |
| V2020 |
Frames, purchases |
573 |
567 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
240 |
239 |
$8K |
| 92370 |
|
295 |
294 |
$7K |
| 92015 |
Determination of refractive state |
464 |
457 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
213 |
212 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
58 |
56 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$428.88 |
| 92341 |
|
13 |
12 |
$378.84 |
| 92250 |
|
12 |
12 |
$342.06 |