| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
620 |
617 |
$19K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
599 |
593 |
$18K |
| V2020 |
Frames, purchases |
31 |
31 |
$3K |
| S0592 |
Comprehensive contact lens evaluation |
25 |
25 |
$876.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$520.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$480.00 |