| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,539 |
2,533 |
$79K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,455 |
1,453 |
$72K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,036 |
1,033 |
$49K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,196 |
2,192 |
$43K |
| 92341 |
|
221 |
221 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
472 |
472 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
286 |
286 |
$3K |
| 92015 |
Determination of refractive state |
29 |
29 |
$177.44 |