| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
885 |
804 |
$55K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
809 |
792 |
$33K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
754 |
679 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
233 |
211 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
132 |
129 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
104 |
102 |
$4K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
25 |
25 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
115 |
107 |
$1K |
| 92015 |
Determination of refractive state |
172 |
166 |
$742.50 |
| S0592 |
Comprehensive contact lens evaluation |
13 |
13 |
$472.00 |
| V2025 |
Deluxe frame |
16 |
16 |
$178.20 |