| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
987 |
805 |
$56K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
830 |
660 |
$37K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
766 |
676 |
$34K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
444 |
384 |
$20K |
| V2025 |
Deluxe frame |
779 |
616 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
33 |
33 |
$1K |
| V2020 |
Frames, purchases |
124 |
124 |
$1K |
| 92015 |
Determination of refractive state |
81 |
76 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
18 |
18 |
$810.00 |