| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
477 |
468 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
262 |
262 |
$11K |
| 92015 |
Determination of refractive state |
326 |
323 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
83 |
83 |
$3K |
| 92002 |
|
54 |
53 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
40 |
40 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
113 |
113 |
$2K |
| 92341 |
|
37 |
37 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$741.24 |