| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
601 |
502 |
$18K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
491 |
434 |
$15K |
| V2020 |
Frames, purchases |
96 |
94 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
68 |
68 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
72 |
72 |
$2K |
| 92310 |
|
25 |
18 |
$875.00 |
| 92015 |
Determination of refractive state |
57 |
46 |
$0.00 |
| 92250 |
|
259 |
156 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
26 |
21 |
$0.00 |