| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,660 |
1,645 |
$70K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,503 |
1,432 |
$31K |
| V2020 |
Frames, purchases |
1,707 |
1,609 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
706 |
699 |
$10K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
118 |
117 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
117 |
115 |
$4K |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$345.57 |
| 3072F |
|
242 |
241 |
$0.00 |