| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
976 |
904 |
$29K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
829 |
755 |
$25K |
| V2020 |
Frames, purchases |
237 |
210 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
185 |
172 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
47 |
47 |
$3K |
| 92310 |
|
68 |
55 |
$2K |
| 92002 |
|
24 |
24 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
105 |
104 |
$832.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
14 |
$290.00 |
| 92250 |
|
418 |
287 |
$0.00 |
| 92015 |
Determination of refractive state |
180 |
171 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
20 |
14 |
$0.00 |