| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,383 |
4,355 |
$348K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,109 |
3,092 |
$93K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,386 |
4,348 |
$69K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,841 |
1,830 |
$55K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
334 |
331 |
$22K |
| 92310 |
|
336 |
336 |
$12K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
278 |
277 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
174 |
172 |
$7K |
| 92002 |
|
207 |
205 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
36 |
30 |
$360.00 |
| 92015 |
Determination of refractive state |
15 |
15 |
$67.50 |