| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
200 |
147 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
32 |
31 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
19 |
19 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
201 |
150 |
$370.52 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
193 |
145 |
$0.00 |
| 92015 |
Determination of refractive state |
169 |
165 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
52 |
46 |
$0.00 |