| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,604 |
2,594 |
$130K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,700 |
2,692 |
$129K |
| V2020 |
Frames, purchases |
3,435 |
3,430 |
$98K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,725 |
3,708 |
$73K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,552 |
2,550 |
$42K |
| 92341 |
|
1,377 |
1,373 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
448 |
448 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
363 |
363 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
313 |
313 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
290 |
289 |
$2K |
| 99072 |
|
140 |
139 |
$0.00 |