| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,254 |
1,229 |
$78K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,084 |
1,058 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
597 |
579 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
372 |
364 |
$14K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
108 |
108 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
68 |
68 |
$3K |
| 92015 |
Determination of refractive state |
140 |
140 |
$472.50 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$120.00 |