| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
|
1,312 |
1,218 |
$86K |
| V2025 |
Deluxe frame |
403 |
398 |
$17K |
| V2020 |
Frames, purchases |
892 |
874 |
$16K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
331 |
324 |
$15K |
| 92015 |
|
670 |
668 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
431 |
406 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
380 |
351 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
335 |
329 |
$4K |
| 99203 |
|
46 |
46 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
14 |
14 |
$562.50 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
12 |
$222.24 |