| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
973 |
618 |
$54K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,142 |
733 |
$51K |
| V2020 |
Frames, purchases |
1,005 |
642 |
$16K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
64 |
64 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
55 |
50 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
83 |
72 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
129 |
110 |
$2K |