| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
392 |
275 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
334 |
225 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
399 |
273 |
$4K |
| 92015 |
Determination of refractive state |
476 |
343 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
43 |
43 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
76 |
40 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
185 |
102 |
$0.00 |