| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
7,851 |
7,832 |
$328K |
| V2020 |
Frames, purchases |
12,850 |
12,805 |
$266K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
5,917 |
5,904 |
$251K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13,079 |
13,051 |
$241K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,244 |
7,187 |
$110K |
| 92341 |
|
4,600 |
4,594 |
$97K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
850 |
845 |
$47K |
| 92250 |
|
1,551 |
1,547 |
$38K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,031 |
2,017 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
610 |
557 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,660 |
1,649 |
$24K |
| 92015 |
Determination of refractive state |
1,517 |
1,511 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
936 |
926 |
$15K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
592 |
585 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
150 |
150 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
206 |
197 |
$8K |
| 92083 |
|
167 |
158 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
86 |
85 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
39 |
39 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
51 |
51 |
$2K |
| 92133 |
|
80 |
77 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
98 |
98 |
$1K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
33 |
33 |
$1K |
| 76514 |
|
13 |
13 |
$139.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
330 |
328 |
$0.00 |