| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2750 |
Anti-reflective coating, per lens |
150 |
75 |
$0.00 |
| V2020 |
Frames, purchases |
973 |
971 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
704 |
703 |
$0.00 |
| 92310 |
|
187 |
187 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,102 |
637 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
438 |
437 |
$0.00 |
| 92002 |
|
23 |
23 |
$0.00 |
| 92250 |
|
114 |
114 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
19 |
13 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
84 |
67 |
$0.00 |