| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2499 |
Variable sphericity lens, other type |
598 |
581 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
348 |
339 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
589 |
562 |
$9K |
| V2020 |
Frames, purchases |
616 |
599 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
57 |
57 |
$5K |
| 92015 |
Determination of refractive state |
603 |
588 |
$5K |
| V2750 |
Anti-reflective coating, per lens |
90 |
84 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
193 |
187 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
201 |
194 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
25 |
$2K |
| V2755 |
U-v lens, per lens |
394 |
384 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
68 |
67 |
$0.00 |