| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,881 |
1,269 |
$62K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
683 |
652 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,029 |
1,002 |
$27K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
418 |
408 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
323 |
322 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
300 |
279 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
157 |
156 |
$7K |
| 92065 |
|
96 |
40 |
$4K |
| V2750 |
Anti-reflective coating, per lens |
61 |
59 |
$1K |
| 92015 |
Determination of refractive state |
30 |
30 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
44 |
43 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$537.18 |