| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
872 |
841 |
$41K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
774 |
664 |
$30K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
661 |
555 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
272 |
235 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
339 |
328 |
$7K |
| S0592 |
Comprehensive contact lens evaluation |
187 |
142 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
68 |
38 |
$669.13 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
15 |
$80.00 |
| 92250 |
|
373 |
195 |
$0.00 |
| 92002 |
|
17 |
17 |
$0.00 |
| 92285 |
|
21 |
21 |
$0.00 |