| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
611 |
605 |
$44K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
397 |
395 |
$12K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
194 |
194 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
178 |
176 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
93 |
93 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
57 |
57 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
47 |
46 |
$474.52 |
| 92015 |
Determination of refractive state |
460 |
459 |
$0.00 |