| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
342 |
175 |
$6K |
| V2020 |
Frames, purchases |
462 |
453 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
69 |
67 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
66 |
63 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
46 |
46 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
40 |
40 |
$585.00 |
| 92015 |
Determination of refractive state |
397 |
396 |
$121.60 |
| 3072F |
|
12 |
12 |
$0.00 |