| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
4,025 |
4,012 |
$168K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,035 |
3,030 |
$128K |
| V2020 |
Frames, purchases |
3,807 |
3,792 |
$83K |
| V2599 |
Contact lens, other type |
623 |
621 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,375 |
1,961 |
$43K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,520 |
889 |
$19K |
| 92310 |
|
573 |
572 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
621 |
620 |
$18K |
| V2755 |
U-v lens, per lens |
3,618 |
3,599 |
$16K |
| V2760 |
Scratch resistant coating, per lens |
3,612 |
3,597 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
180 |
179 |
$16K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
761 |
498 |
$10K |
| 92015 |
Determination of refractive state |
636 |
634 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
74 |
74 |
$6K |