| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,099 |
1,061 |
$54K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
497 |
493 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
338 |
255 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
288 |
275 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
232 |
220 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
158 |
143 |
$6K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
190 |
190 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
410 |
402 |
$4K |
| 92015 |
Determination of refractive state |
834 |
820 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
158 |
124 |
$3K |
| 92310 |
|
15 |
14 |
$495.00 |