| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
770 |
630 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
216 |
170 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
414 |
329 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
69 |
42 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
127 |
127 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
79 |
50 |
$703.20 |