| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,409 |
1,256 |
$22K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
379 |
372 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
680 |
630 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
924 |
648 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
328 |
327 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
656 |
489 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
95 |
83 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
117 |
86 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
32 |
32 |
$2K |
| 92341 |
|
13 |
13 |
$412.23 |
| 92015 |
Determination of refractive state |
594 |
528 |
$0.00 |