| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
712 |
669 |
$53K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
548 |
528 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
107 |
100 |
$3K |
| 92015 |
Determination of refractive state |
374 |
366 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
85 |
83 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
41 |
41 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26 |
26 |
$599.75 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
13 |
$500.50 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
13 |
13 |
$390.00 |