| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,970 |
1,921 |
$106K |
| V2020 |
Frames, purchases |
2,875 |
2,741 |
$82K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,647 |
1,572 |
$68K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,779 |
2,690 |
$49K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
942 |
904 |
$47K |
| V2750 |
Anti-reflective coating, per lens |
1,714 |
1,652 |
$42K |
| V2025 |
Deluxe frame |
1,008 |
1,004 |
$41K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,149 |
1,131 |
$19K |