| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
7,243 |
7,231 |
$173K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,840 |
2,839 |
$101K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,694 |
4,677 |
$72K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,895 |
1,895 |
$67K |
| 92341 |
|
2,667 |
2,664 |
$47K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,031 |
3,025 |
$35K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,186 |
2,184 |
$34K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
867 |
866 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
449 |
446 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
163 |
163 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
52 |
52 |
$658.55 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
300 |
299 |
$0.00 |