| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
245 |
239 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
181 |
175 |
$6K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
125 |
123 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$462.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$448.29 |
| 92015 |
Determination of refractive state |
56 |
56 |
$303.44 |