| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
861 |
820 |
$26K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
755 |
727 |
$23K |
| V2020 |
Frames, purchases |
154 |
151 |
$13K |
| 92310 |
|
50 |
40 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
78 |
77 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$310.35 |
| 92015 |
Determination of refractive state |
368 |
345 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
50 |
40 |
$0.00 |
| 92250 |
|
218 |
158 |
$0.00 |