| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,343 |
3,195 |
$280K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,627 |
1,558 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
875 |
864 |
$39K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,233 |
1,206 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
300 |
284 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
230 |
221 |
$7K |
| 92015 |
Determination of refractive state |
3,441 |
3,333 |
$5K |
| 92310 |
|
143 |
139 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
79 |
50 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
99 |
95 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
65 |
62 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
29 |
28 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
100 |
48 |
$0.00 |