| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
209 |
199 |
$11K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
157 |
154 |
$10K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
130 |
129 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
145 |
139 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
32 |
32 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
27 |
$900.00 |