| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
310 |
309 |
$6K |
| 92015 |
Determination of refractive state |
442 |
433 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
87 |
86 |
$5K |
| V2020 |
Frames, purchases |
85 |
83 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
28 |
28 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
12 |
12 |
$603.67 |
| 92341 |
|
12 |
12 |
$270.96 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
16 |
$153.24 |