| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,983 |
1,834 |
$112K |
| V2020 |
Frames, purchases |
2,519 |
2,291 |
$78K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,407 |
1,350 |
$77K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,710 |
1,541 |
$33K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
702 |
620 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
434 |
399 |
$10K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
95 |
90 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
78 |
69 |
$2K |