| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
464 |
449 |
$22K |
| V2020 |
Frames, purchases |
1,088 |
1,026 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
520 |
501 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
634 |
597 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
148 |
118 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
36 |
36 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
31 |
31 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
101 |
92 |
$708.50 |
| 92015 |
Determination of refractive state |
107 |
95 |
$0.00 |