| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,826 |
2,710 |
$85K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,729 |
2,625 |
$71K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
865 |
812 |
$70K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,188 |
1,135 |
$69K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
550 |
517 |
$53K |
| 92015 |
Determination of refractive state |
2,350 |
2,206 |
$48K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,603 |
1,537 |
$30K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
358 |
350 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,892 |
2,775 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
109 |
92 |
$4K |
| 00000 |
|
58 |
14 |
$2K |
| 92341 |
|
28 |
28 |
$942.27 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
31 |
$852.66 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
68 |
65 |
$552.22 |
| 92250 |
|
13 |
13 |
$204.16 |