| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
432 |
257 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
209 |
196 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
249 |
156 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
285 |
157 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
41 |
27 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
236 |
134 |
$596.21 |
| 92015 |
Determination of refractive state |
318 |
292 |
$109.83 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
306 |
158 |
$20.00 |
| 92083 |
|
23 |
12 |
$0.00 |
| 92341 |
|
62 |
42 |
$0.00 |