| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,285 |
1,753 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,147 |
1,072 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,054 |
979 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,144 |
810 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
540 |
382 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,066 |
704 |
$5K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
109 |
81 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
108 |
93 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
37 |
37 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
53 |
39 |
$1K |
| 92310 |
|
19 |
13 |
$199.20 |
| 92015 |
Determination of refractive state |
1,404 |
1,271 |
$0.00 |