| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,937 |
6,143 |
$170K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,398 |
3,242 |
$168K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,664 |
2,599 |
$127K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,390 |
5,675 |
$123K |
| V2750 |
Anti-reflective coating, per lens |
2,320 |
2,091 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,579 |
3,353 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$380.75 |