| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
106 |
101 |
$0.00 |
| 92015 |
Determination of refractive state |
274 |
256 |
$0.00 |
| V2025 |
Deluxe frame |
155 |
133 |
$0.00 |
| V2020 |
Frames, purchases |
349 |
246 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
115 |
100 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
58 |
58 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$0.00 |