| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
325 |
304 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
56 |
55 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
14 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
131 |
112 |
$1K |
| 92015 |
Determination of refractive state |
417 |
399 |
$942.40 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
227 |
206 |
$440.15 |
| V2755 |
U-v lens, per lens |
121 |
108 |
$84.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
28 |
24 |
$0.00 |