| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,407 |
2,389 |
$69K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,357 |
1,349 |
$61K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,400 |
2,361 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,531 |
1,269 |
$19K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
418 |
414 |
$19K |
| 92341 |
|
371 |
371 |
$8K |
| 92015 |
Determination of refractive state |
171 |
162 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
153 |
132 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
12 |
$141.86 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
475 |
473 |
$0.00 |