| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
769 |
767 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,452 |
1,446 |
$29K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
341 |
338 |
$16K |
| V2020 |
Frames, purchases |
484 |
480 |
$10K |
| 92015 |
Determination of refractive state |
895 |
861 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
218 |
212 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
96 |
96 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
27 |
$1K |
| 92341 |
|
49 |
49 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
14 |
$611.87 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$73.65 |