| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,849 |
1,829 |
$83K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,479 |
1,466 |
$37K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,202 |
1,201 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
946 |
929 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
395 |
394 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
454 |
453 |
$15K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
258 |
258 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
111 |
95 |
$4K |
| 92015 |
Determination of refractive state |
141 |
141 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
14 |
$905.10 |