| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,127 |
1,085 |
$45K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
487 |
472 |
$19K |
| V2020 |
Frames, purchases |
971 |
913 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
578 |
553 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
828 |
786 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
176 |
175 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
143 |
132 |
$2K |