| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
3,605 |
2,054 |
$570K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,640 |
3,462 |
$359K |
| V2020 |
Frames, purchases |
5,453 |
3,238 |
$218K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,042 |
2,070 |
$162K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,626 |
3,255 |
$150K |
| V2750 |
Anti-reflective coating, per lens |
4,814 |
2,798 |
$120K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,803 |
3,415 |
$105K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
870 |
821 |
$98K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
369 |
172 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
81 |
53 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| 92250 |
|
12 |
12 |
$585.01 |