| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,957 |
1,897 |
$60K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,496 |
1,443 |
$29K |
| 92015 |
Determination of refractive state |
1,025 |
989 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
217 |
197 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
182 |
181 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
810 |
760 |
$8K |
| 92341 |
|
39 |
39 |
$820.29 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$176.54 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$151.28 |