| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
368 |
355 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
286 |
280 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
227 |
221 |
$8K |
| 92015 |
Determination of refractive state |
549 |
535 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
254 |
253 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
326 |
313 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
245 |
235 |
$3K |
| 92250 |
|
43 |
43 |
$0.00 |