| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
564 |
538 |
$28K |
| V2020 |
Frames, purchases |
1,311 |
1,261 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
785 |
747 |
$22K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
384 |
359 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
492 |
470 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
285 |
280 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
219 |
204 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
413 |
392 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$390.00 |
| 92015 |
Determination of refractive state |
225 |
219 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
26 |
26 |
$0.00 |