| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,923 |
1,907 |
$143K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,469 |
1,462 |
$44K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,094 |
1,027 |
$38K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,371 |
1,356 |
$34K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
523 |
516 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
573 |
564 |
$29K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
409 |
408 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
188 |
188 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
94 |
93 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
149 |
148 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
175 |
175 |
$2K |
| 92310 |
|
15 |
15 |
$413.00 |
| 92015 |
Determination of refractive state |
84 |
84 |
$378.00 |