| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,657 |
2,402 |
$79K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,330 |
1,270 |
$40K |
| V2020 |
Frames, purchases |
534 |
524 |
$29K |
| 92310 |
|
534 |
422 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
297 |
284 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
355 |
349 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
56 |
55 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$455.00 |
| 92015 |
Determination of refractive state |
579 |
498 |
$0.00 |
| 92250 |
|
868 |
581 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
29 |
27 |
$0.00 |