| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,662 |
1,488 |
$97K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
924 |
604 |
$34K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
761 |
755 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
433 |
415 |
$18K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
144 |
142 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
412 |
198 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
67 |
67 |
$3K |
| 92310 |
|
72 |
72 |
$2K |
| 92015 |
Determination of refractive state |
294 |
292 |
$1K |