| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
122 |
121 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
66 |
66 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
43 |
43 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
115 |
113 |
$291.99 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
125 |
123 |
$0.00 |
| 92015 |
Determination of refractive state |
140 |
139 |
$0.00 |