| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,283 |
1,265 |
$62K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,183 |
2,139 |
$61K |
| V2025 |
Deluxe frame |
928 |
919 |
$40K |
| V2020 |
Frames, purchases |
2,025 |
1,982 |
$40K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
799 |
790 |
$38K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,064 |
1,054 |
$12K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
14 |
$827.40 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
15 |
$380.52 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
12 |
12 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
13 |
12 |
$0.00 |
| 1036F |
|
13 |
12 |
$0.00 |