| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
7,246 |
7,194 |
$312K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,571 |
5,307 |
$304K |
| V2020 |
Frames, purchases |
14,522 |
14,240 |
$271K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12,017 |
11,805 |
$250K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,888 |
9,756 |
$193K |
| V2025 |
Deluxe frame |
4,852 |
4,829 |
$179K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
3,503 |
3,482 |
$151K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,007 |
2,905 |
$87K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
4,362 |
4,267 |
$79K |
| 92015 |
Determination of refractive state |
7,157 |
6,994 |
$76K |
| 92002 |
|
964 |
922 |
$53K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
490 |
476 |
$44K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
941 |
929 |
$17K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
536 |
526 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
200 |
191 |
$12K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
601 |
591 |
$10K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
160 |
158 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$416.77 |
| 3072F |
|
250 |
248 |
$10.00 |