| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
367 |
358 |
$12K |
| 92015 |
Determination of refractive state |
642 |
614 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
79 |
78 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
294 |
288 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
44 |
44 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
54 |
54 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
27 |
$680.68 |
| 2033F |
|
85 |
84 |
$0.00 |