| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
363 |
359 |
$19K |
| V2020 |
Frames, purchases |
549 |
533 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
561 |
544 |
$12K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
183 |
180 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
58 |
56 |
$6K |
| 92015 |
Determination of refractive state |
303 |
296 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
15 |
$1K |