| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,320 |
1,189 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
512 |
499 |
$36K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
272 |
268 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
610 |
440 |
$8K |
| 92015 |
Determination of refractive state |
1,264 |
1,221 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
994 |
883 |
$997.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
865 |
469 |
$36.54 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
125 |
76 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
12 |
12 |
$0.00 |