| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
980 |
484 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
335 |
334 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
546 |
268 |
$0.00 |
| V2020 |
Frames, purchases |
549 |
541 |
$0.00 |
| 92015 |
Determination of refractive state |
326 |
325 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
750 |
748 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
148 |
73 |
$0.00 |