| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,396 |
3,340 |
$157K |
| V2020 |
Frames, purchases |
3,696 |
3,621 |
$92K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,859 |
2,813 |
$52K |
| 92341 |
|
1,158 |
1,128 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,387 |
1,366 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
630 |
613 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
432 |
411 |
$6K |
| 92015 |
Determination of refractive state |
248 |
237 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
49 |
49 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$198.32 |
| 3072F |
|
184 |
184 |
$0.00 |