| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,776 |
2,768 |
$88K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,146 |
2,138 |
$44K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
816 |
815 |
$40K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
601 |
599 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,319 |
1,243 |
$16K |
| 92341 |
|
148 |
148 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
263 |
253 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
76 |
38 |
$645.24 |