| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,563 |
1,521 |
$59K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,332 |
1,298 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
273 |
269 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,189 |
741 |
$13K |
| 92015 |
Determination of refractive state |
881 |
857 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
56 |
52 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
78 |
74 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
67 |
67 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
36 |
26 |
$646.41 |