| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,491 |
1,488 |
$67K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
834 |
832 |
$58K |
| V2020 |
Frames, purchases |
2,202 |
2,199 |
$53K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,393 |
2,392 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,349 |
1,126 |
$24K |
| 92341 |
|
899 |
899 |
$21K |
| 92015 |
Determination of refractive state |
1,185 |
1,185 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
460 |
396 |
$7K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
189 |
155 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
55 |
55 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
15 |
$1K |