| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,739 |
1,710 |
$96K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,287 |
1,269 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
969 |
951 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,158 |
1,138 |
$26K |
| 92250 |
|
362 |
344 |
$16K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
208 |
205 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
40 |
40 |
$1K |