| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,803 |
1,717 |
$82K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,212 |
1,144 |
$63K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
291 |
282 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$569.00 |
| V2020 |
Frames, purchases |
33 |
19 |
$442.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
23 |
16 |
$274.00 |