| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
923 |
909 |
$29K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
614 |
606 |
$12K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
231 |
226 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
187 |
184 |
$8K |
| 92341 |
|
282 |
276 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
620 |
612 |
$6K |
| 92082 |
|
356 |
350 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
246 |
241 |
$3K |
| V2715 |
Prism, per lens |
551 |
541 |
$3K |
| V2756 |
Eye glass case |
829 |
816 |
$1.08 |