| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
3,237 |
3,169 |
$138K |
| V2020 |
Frames, purchases |
3,603 |
3,476 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,844 |
1,775 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
584 |
564 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
398 |
387 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
69 |
69 |
$135.00 |