| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
243 |
239 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
178 |
178 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
167 |
165 |
$7K |
| 92015 |
Determination of refractive state |
388 |
384 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
190 |
190 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
223 |
219 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
222 |
219 |
$3K |