| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,727 |
1,648 |
$97K |
| V2020 |
Frames, purchases |
2,183 |
2,152 |
$95K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,117 |
1,108 |
$34K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
776 |
773 |
$31K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
527 |
508 |
$28K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
140 |
140 |
$4K |
| V2025 |
Deluxe frame |
182 |
175 |
$2K |
| 92002 |
|
48 |
45 |
$2K |
| 92015 |
Determination of refractive state |
84 |
83 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
66 |
61 |
$1K |