| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
16,282 |
16,091 |
$473K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
7,141 |
7,087 |
$315K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
5,127 |
5,100 |
$238K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12,084 |
11,938 |
$224K |
| 92341 |
|
3,092 |
3,069 |
$65K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,118 |
5,860 |
$59K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,511 |
5,248 |
$49K |
| V2715 |
Prism, per lens |
10,127 |
9,600 |
$47K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,800 |
1,718 |
$22K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,585 |
1,524 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
207 |
200 |
$16K |
| 92015 |
Determination of refractive state |
1,315 |
1,291 |
$13K |
| 92082 |
|
757 |
748 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
106 |
106 |
$7K |
| 92342 |
|
178 |
174 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
256 |
254 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
25 |
$2K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
75 |
72 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
194 |
194 |
$2K |
| V2756 |
Eye glass case |
1,843 |
1,820 |
$180.36 |