| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
661 |
637 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,558 |
1,494 |
$45K |
| 92015 |
Determination of refractive state |
736 |
690 |
$27K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
278 |
260 |
$24K |
| V2020 |
Frames, purchases |
1,074 |
1,003 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
337 |
309 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
251 |
231 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,038 |
570 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
264 |
240 |
$6K |
| 92002 |
|
108 |
102 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
342 |
198 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
56 |
45 |
$3K |