| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
246 |
240 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
171 |
164 |
$7K |
| 92015 |
Determination of refractive state |
468 |
453 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
100 |
98 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
164 |
164 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
211 |
201 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
150 |
146 |
$2K |
| 92250 |
|
16 |
16 |
$0.00 |