| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,015 |
5,953 |
$266K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,085 |
3,076 |
$214K |
| V2020 |
Frames, purchases |
6,727 |
6,652 |
$211K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,822 |
1,820 |
$122K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
312 |
310 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
366 |
365 |
$34K |
| 92015 |
Determination of refractive state |
1,008 |
1,006 |
$17K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
372 |
364 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
85 |
85 |
$3K |