| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,944 |
1,909 |
$82K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
394 |
394 |
$54K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
720 |
346 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
460 |
460 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
89 |
89 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
38 |
38 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
49 |
49 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
950 |
459 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
16 |
16 |
$818.36 |