| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,681 |
5,647 |
$154K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,060 |
6,016 |
$118K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,554 |
2,553 |
$115K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,364 |
2,350 |
$112K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,344 |
2,336 |
$41K |
| 92341 |
|
1,766 |
1,762 |
$40K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
792 |
791 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,374 |
1,369 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
282 |
280 |
$15K |
| 92250 |
|
324 |
322 |
$7K |
| 92015 |
Determination of refractive state |
793 |
789 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
113 |
112 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61 |
61 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
102 |
101 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$604.20 |
| 92002 |
|
12 |
12 |
$600.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
282 |
279 |
$438.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$245.60 |
| 2026F |
|
480 |
476 |
$0.00 |
| 2025F |
|
116 |
116 |
$0.00 |
| 2022F |
|
12 |
12 |
$0.00 |
| 3072F |
|
75 |
75 |
$0.00 |