| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,146 |
1,138 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
512 |
511 |
$10K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
95 |
95 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
318 |
208 |
$2K |
| 92015 |
Determination of refractive state |
176 |
176 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$867.25 |