| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
805 |
796 |
$17K |
| V2020 |
Frames, purchases |
406 |
404 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
123 |
123 |
$10K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
163 |
160 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
88 |
88 |
$6K |
| 92015 |
Determination of refractive state |
433 |
424 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
241 |
240 |
$3K |
| 92060 |
|
60 |
59 |
$2K |
| 92341 |
|
62 |
60 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
26 |
26 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$270.50 |
| V2756 |
Eye glass case |
78 |
78 |
$21.06 |