| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,091 |
2,998 |
$126K |
| S0592 |
Comprehensive contact lens evaluation |
756 |
740 |
$52K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,167 |
1,149 |
$46K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,512 |
2,329 |
$45K |
| V2020 |
Frames, purchases |
2,510 |
2,341 |
$36K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,385 |
2,226 |
$23K |
| V2500 |
Contact lens, pmma, spherical, per lens |
1,199 |
1,133 |
$14K |
| 92310 |
|
288 |
266 |
$6K |
| 92002 |
|
28 |
28 |
$337.50 |
| 92012 |
|
49 |
49 |
$202.50 |
| 92004 |
|
97 |
89 |
$168.75 |