| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,948 |
2,811 |
$43K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,235 |
2,123 |
$40K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,452 |
1,357 |
$35K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,347 |
1,294 |
$32K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
567 |
550 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
827 |
779 |
$8K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
14 |
14 |
$700.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
12 |
12 |
$600.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
18 |
18 |
$473.96 |