| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
755 |
464 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
660 |
611 |
$11K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
266 |
182 |
$9K |
| V2020 |
Frames, purchases |
567 |
547 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
176 |
166 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
50 |
48 |
$0.00 |
| 92015 |
Determination of refractive state |
35 |
33 |
$0.00 |