| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
348 |
347 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
241 |
240 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
77 |
77 |
$0.00 |
| V2020 |
Frames, purchases |
662 |
660 |
$0.00 |
| 92015 |
Determination of refractive state |
154 |
154 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
250 |
248 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
112 |
112 |
$0.00 |