| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,144 |
2,129 |
$61K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,137 |
1,131 |
$53K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,036 |
1,033 |
$50K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,467 |
2,442 |
$48K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,078 |
1,033 |
$16K |
| 92341 |
|
96 |
95 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$160.32 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
214 |
213 |
$0.00 |