| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
589 |
541 |
$23K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
574 |
521 |
$22K |
| V2020 |
Frames, purchases |
979 |
871 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
724 |
637 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
460 |
415 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
476 |
447 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
87 |
81 |
$2K |
| 3072F |
|
19 |
12 |
$0.00 |