| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,010 |
1,980 |
$117K |
| V2020 |
Frames, purchases |
2,746 |
2,658 |
$57K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
752 |
729 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,424 |
1,402 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
396 |
394 |
$31K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
427 |
411 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
266 |
265 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
127 |
122 |
$6K |
| 92015 |
Determination of refractive state |
315 |
315 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
181 |
180 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
169 |
164 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
24 |
24 |
$2K |