| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
787 |
780 |
$34K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
306 |
306 |
$14K |
| V2020 |
Frames, purchases |
83 |
80 |
$7K |
| S0592 |
Comprehensive contact lens evaluation |
128 |
128 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
62 |
62 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
53 |
53 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
46 |
46 |
$948.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$658.46 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$645.62 |
| 92015 |
Determination of refractive state |
73 |
71 |
$261.00 |