| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
283 |
259 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
75 |
73 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
53 |
51 |
$3K |
| 92015 |
Determination of refractive state |
427 |
396 |
$270.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
251 |
228 |
$151.90 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
245 |
225 |
$39.88 |