| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
198 |
156 |
$10K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
72 |
70 |
$5K |
| V2020 |
Frames, purchases |
338 |
278 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
92 |
77 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$390.00 |
| 92015 |
Determination of refractive state |
25 |
24 |
$102.00 |
| 1036F |
|
12 |
12 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
13 |
13 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
13 |
13 |
$0.00 |