| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,162 |
2,126 |
$94K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,073 |
1,959 |
$84K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,426 |
1,386 |
$57K |
| V2025 |
Deluxe frame |
1,114 |
1,106 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,502 |
1,477 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
941 |
914 |
$21K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
696 |
639 |
$14K |