| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
5,612 |
5,557 |
$0.00 |
| V2020 |
Frames, purchases |
8,348 |
8,270 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,086 |
2,056 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
169 |
169 |
$0.00 |
| 92015 |
|
296 |
292 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
51 |
51 |
$0.00 |
| 92340 |
|
253 |
250 |
$0.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
83 |
82 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,999 |
2,980 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,773 |
3,744 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,127 |
1,110 |
$0.00 |
| 92004 |
|
3,373 |
3,357 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
97 |
96 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
34 |
34 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
24 |
24 |
$0.00 |