| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,417 |
2,375 |
$73K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
707 |
704 |
$35K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,492 |
1,462 |
$29K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
404 |
396 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,442 |
986 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
674 |
474 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
49 |
49 |
$3K |
| V2756 |
Eye glass case |
553 |
522 |
$59.13 |