| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
206 |
203 |
$7K |
| 92015 |
Determination of refractive state |
256 |
252 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
39 |
39 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
186 |
182 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
29 |
27 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
57 |
56 |
$2K |