| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
253 |
246 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
333 |
330 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
534 |
524 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
64 |
61 |
$5K |
| 92015 |
Determination of refractive state |
235 |
235 |
$494.63 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
67 |
67 |
$338.31 |
| 2023F |
|
338 |
338 |
$0.00 |
| V2025 |
Deluxe frame |
383 |
375 |
$0.00 |
| V2020 |
Frames, purchases |
46 |
46 |
$0.00 |