| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
996 |
852 |
$30K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
734 |
652 |
$22K |
| V2020 |
Frames, purchases |
45 |
45 |
$4K |
| 92310 |
|
90 |
53 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
26 |
26 |
$690.70 |
| 92250 |
|
771 |
532 |
$0.00 |
| 92015 |
Determination of refractive state |
128 |
123 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
26 |
13 |
$0.00 |