| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
970 |
919 |
$21K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
468 |
451 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
682 |
652 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
335 |
322 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
353 |
336 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
95 |
93 |
$2K |
| S0500 |
Disposable contact lens, per lens |
24 |
24 |
$1K |