| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,010 |
2,007 |
$47K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,075 |
1,075 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,321 |
1,317 |
$22K |
| 92341 |
|
933 |
930 |
$19K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
505 |
505 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
420 |
419 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
127 |
127 |
$2K |
| V2756 |
Eye glass case |
134 |
133 |
$3.78 |