| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,647 |
2,614 |
$161K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,018 |
2,980 |
$91K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,883 |
1,866 |
$57K |
| V2760 |
Scratch resistant coating, per lens |
633 |
625 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
294 |
289 |
$5K |
| S0500 |
Disposable contact lens, per lens |
66 |
65 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
150 |
150 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
65 |
65 |
$2K |
| 92310 |
|
69 |
67 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
43 |
43 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$308.00 |