| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
35 |
35 |
$3K |
| V2020 |
Frames, purchases |
56 |
56 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
80 |
80 |
$0.00 |
| V2599 |
Contact lens, other type |
13 |
13 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
24 |
24 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
25 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
42 |
21 |
$0.00 |