| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
583 |
560 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
347 |
337 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
426 |
410 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
252 |
246 |
$8K |
| 92015 |
Determination of refractive state |
880 |
854 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
124 |
118 |
$6K |
| V2756 |
Eye glass case |
590 |
571 |
$703.59 |
| V2025 |
Deluxe frame |
34 |
34 |
$0.00 |