| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
259 |
245 |
$10K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
241 |
238 |
$10K |
| V2020 |
Frames, purchases |
505 |
486 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
444 |
423 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
304 |
293 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
44 |
43 |
$612.42 |
| V2025 |
Deluxe frame |
24 |
22 |
$532.05 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$101.25 |