| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
680 |
668 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
286 |
282 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
405 |
399 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
64 |
63 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
28 |
28 |
$286.00 |
| 92015 |
Determination of refractive state |
768 |
756 |
$0.00 |