| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
422 |
417 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
256 |
203 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
253 |
228 |
$5K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
150 |
150 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
73 |
71 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
39 |
39 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
35 |
33 |
$1K |