| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
310 |
280 |
$14K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
227 |
198 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
74 |
73 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
46 |
44 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
104 |
90 |
$2K |
| V2020 |
Frames, purchases |
109 |
107 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
83 |
83 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
66 |
65 |
$993.95 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
17 |
17 |
$758.30 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
24 |
$621.56 |
| 92015 |
Determination of refractive state |
118 |
115 |
$0.00 |