| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
95 |
91 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
90 |
86 |
$4K |
| V2020 |
Frames, purchases |
187 |
176 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
97 |
94 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
51 |
48 |
$544.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
13 |
$228.45 |