| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
227 |
224 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
155 |
150 |
$8K |
| V2020 |
Frames, purchases |
238 |
236 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
81 |
81 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
135 |
134 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$822.90 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14 |
13 |
$593.03 |