| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
251 |
251 |
$21K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
400 |
397 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
242 |
242 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
805 |
801 |
$15K |
| 92015 |
Determination of refractive state |
535 |
535 |
$6K |
| 92341 |
|
169 |
169 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
59 |
59 |
$3K |
| 92250 |
|
106 |
106 |
$2K |
| V2020 |
Frames, purchases |
124 |
124 |
$671.90 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$9.82 |