| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,053 |
1,048 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,271 |
1,266 |
$24K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
316 |
316 |
$14K |
| 92341 |
|
374 |
373 |
$9K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
180 |
180 |
$8K |
| 92015 |
Determination of refractive state |
388 |
387 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
268 |
268 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
16 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$193.25 |
| 92285 |
|
16 |
16 |
$187.04 |