| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
320 |
320 |
$0.00 |
| V2020 |
Frames, purchases |
446 |
445 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
76 |
38 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
195 |
195 |
$0.00 |
| V2599 |
Contact lens, other type |
50 |
50 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
80 |
40 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
188 |
93 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
154 |
77 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
52 |
26 |
$0.00 |