| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,694 |
1,635 |
$97K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
642 |
573 |
$42K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
882 |
822 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
620 |
615 |
$25K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
111 |
111 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
67 |
58 |
$2K |
| 92015 |
Determination of refractive state |
67 |
64 |
$1K |
| V2025 |
Deluxe frame |
65 |
61 |
$832.08 |