| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,040 |
2,028 |
$72K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,114 |
2,101 |
$65K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,648 |
1,638 |
$54K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
223 |
222 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
76 |
74 |
$3K |
| 92015 |
Determination of refractive state |
186 |
182 |
$731.45 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
18 |
18 |
$112.00 |