| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,749 |
6,742 |
$182K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,038 |
3,028 |
$129K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,949 |
2,943 |
$125K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,167 |
6,162 |
$113K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,351 |
1,344 |
$103K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,055 |
1,046 |
$68K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,840 |
3,835 |
$50K |
| 92341 |
|
1,635 |
1,633 |
$35K |
| 92015 |
Determination of refractive state |
2,371 |
2,355 |
$27K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,040 |
1,037 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,214 |
1,211 |
$15K |
| V2025 |
Deluxe frame |
63 |
63 |
$118.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
213 |
213 |
$114.00 |
| 2026F |
|
791 |
774 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
53 |
53 |
$0.00 |