| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,289 |
929 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
379 |
350 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
190 |
182 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,182 |
828 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,180 |
828 |
$3K |
| 92015 |
Determination of refractive state |
825 |
773 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
31 |
28 |
$921.42 |
| 92341 |
|
14 |
12 |
$0.00 |