| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
979 |
950 |
$35K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
978 |
963 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
843 |
821 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
526 |
514 |
$16K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
376 |
373 |
$11K |
| V2760 |
Scratch resistant coating, per lens |
323 |
315 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
82 |
82 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
62 |
62 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$423.82 |