| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,124 |
1,113 |
$99K |
| V2020 |
Frames, purchases |
1,809 |
1,783 |
$45K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,073 |
1,060 |
$44K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
491 |
487 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
261 |
257 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
288 |
285 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
580 |
574 |
$5K |