| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2628 |
Fabrication and fitting of ocular conformer |
3,147 |
2,209 |
$474K |
| V2623 |
Prosthetic eye, plastic, custom |
407 |
369 |
$399K |
| V2627 |
Scleral cover shell |
159 |
145 |
$191K |
| V2624 |
Polishing/resurfacing of ocular prosthesis |
3,974 |
3,614 |
$121K |
| 99215 |
Prolong outpt/office vis |
951 |
905 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
645 |
633 |
$10K |
| V2625 |
Enlargement of ocular prosthesis |
27 |
24 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
58 |
$2K |