| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,007 |
2,991 |
$96K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,280 |
1,278 |
$68K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,037 |
1,036 |
$53K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,540 |
2,528 |
$52K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
603 |
597 |
$37K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,131 |
1,375 |
$18K |
| 92341 |
|
673 |
666 |
$15K |
| 92015 |
Determination of refractive state |
985 |
978 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,231 |
777 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
47 |
47 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
240 |
148 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
64 |
64 |
$0.00 |