| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,747 |
6,701 |
$210K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,997 |
5,954 |
$121K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,160 |
2,144 |
$102K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,001 |
990 |
$49K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
556 |
554 |
$46K |
| 92015 |
Determination of refractive state |
3,857 |
3,828 |
$41K |
| 92341 |
|
1,662 |
1,650 |
$38K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,220 |
3,084 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
427 |
425 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,255 |
1,156 |
$15K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
882 |
833 |
$11K |
| 92370 |
|
249 |
249 |
$5K |
| 92002 |
|
54 |
54 |
$2K |
| 92225 |
|
140 |
80 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
40 |
40 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
58 |
53 |
$849.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
32 |
30 |
$601.82 |