| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,499 |
1,498 |
$45K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
579 |
579 |
$26K |
| 92015 |
Determination of refractive state |
1,256 |
1,249 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
575 |
575 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
171 |
171 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
104 |
102 |
$7K |
| 92341 |
|
148 |
148 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
54 |
54 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
123 |
123 |
$2K |
| 99406 |
|
249 |
245 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
159 |
159 |
$0.00 |