| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,042 |
2,011 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,229 |
1,213 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
993 |
978 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
685 |
674 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
216 |
214 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
582 |
577 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
157 |
156 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
17 |
17 |
$510.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$264.50 |