| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
529 |
471 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
145 |
92 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
132 |
102 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
543 |
423 |
$2K |
| 92015 |
Determination of refractive state |
528 |
419 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
235 |
223 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
24 |
12 |
$0.00 |
| V2025 |
Deluxe frame |
28 |
15 |
$0.00 |