| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,558 |
1,287 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
710 |
657 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
874 |
630 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
685 |
596 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
161 |
140 |
$6K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
106 |
98 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
165 |
163 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
927 |
659 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
109 |
67 |
$995.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
12 |
$263.00 |
| 92015 |
Determination of refractive state |
1,222 |
1,044 |
$0.00 |