| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
368 |
326 |
$18K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
335 |
303 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
288 |
254 |
$7K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
189 |
178 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
88 |
88 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
39 |
28 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$450.00 |
| 92250 |
|
52 |
26 |
$0.00 |