| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
381 |
376 |
$9K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
168 |
166 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
182 |
182 |
$3K |
| 92082 |
|
145 |
143 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
50 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
157 |
156 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
36 |
36 |
$1K |
| V2715 |
Prism, per lens |
66 |
65 |
$249.22 |
| V2756 |
Eye glass case |
13 |
13 |
$2.43 |