| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
331 |
329 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
175 |
174 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
165 |
164 |
$3K |
| 92002 |
|
70 |
70 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
141 |
139 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$312.50 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14 |
13 |
$60.00 |
| 92015 |
Determination of refractive state |
235 |
232 |
$0.00 |