| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
859 |
854 |
$17K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
193 |
193 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
103 |
102 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
85 |
82 |
$5K |
| 92015 |
Determination of refractive state |
454 |
446 |
$5K |
| 92341 |
|
218 |
212 |
$5K |
| V2020 |
Frames, purchases |
150 |
149 |
$5K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
12 |
12 |
$591.96 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$189.73 |