| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
117 |
109 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
17 |
16 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
122 |
115 |
$0.00 |
| V2020 |
Frames, purchases |
171 |
147 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
124 |
116 |
$0.00 |
| 92015 |
Determination of refractive state |
203 |
178 |
$0.00 |
| V2025 |
Deluxe frame |
46 |
36 |
$0.00 |