| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,850 |
2,792 |
$188K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,060 |
965 |
$74K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,797 |
1,783 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,095 |
1,053 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
628 |
611 |
$29K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
384 |
378 |
$12K |
| 92250 |
|
153 |
153 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
201 |
201 |
$8K |
| V2500 |
Contact lens, pmma, spherical, per lens |
40 |
38 |
$3K |
| V2025 |
Deluxe frame |
153 |
149 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58 |
58 |
$2K |