| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
185 |
161 |
$6K |
| V2020 |
Frames, purchases |
171 |
145 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
106 |
74 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
106 |
106 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
99 |
99 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
17 |
17 |
$680.00 |