| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,397 |
1,315 |
$61K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
537 |
523 |
$24K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
491 |
463 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
951 |
917 |
$16K |
| 92250 |
|
292 |
244 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
40 |
38 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
471 |
411 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$819.00 |
| 92015 |
Determination of refractive state |
121 |
97 |
$705.16 |