| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 65778 |
|
1,892 |
1,003 |
$1.18M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
139 |
130 |
$12K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
223 |
215 |
$7K |
| 92015 |
Determination of refractive state |
358 |
339 |
$5K |
| V2020 |
Frames, purchases |
166 |
163 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
166 |
164 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
25 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
20 |
20 |
$680.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
119 |
117 |
$356.00 |