| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
54 |
54 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
50 |
50 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
40 |
40 |
$0.00 |
| 92015 |
Determination of refractive state |
63 |
63 |
$0.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
67 |
54 |
$0.00 |
| 92250 |
|
12 |
12 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
33 |
29 |
$0.00 |