| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,657 |
1,649 |
$80K |
| V2020 |
Frames, purchases |
2,473 |
2,456 |
$77K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,517 |
2,501 |
$49K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
956 |
951 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,546 |
1,400 |
$19K |
| 92250 |
|
458 |
457 |
$16K |
| 92341 |
|
196 |
196 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
273 |
231 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
54 |
$1K |
| 92015 |
Determination of refractive state |
127 |
126 |
$11.09 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
96 |
96 |
$0.00 |