| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,429 |
1,385 |
$45K |
| V2020 |
Frames, purchases |
1,656 |
1,582 |
$43K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,347 |
1,296 |
$28K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
573 |
556 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,350 |
1,293 |
$14K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
262 |
247 |
$8K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
101 |
101 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
160 |
157 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
123 |
118 |
$3K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
28 |
28 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24 |
24 |
$2K |
| 92310 |
|
46 |
45 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
12 |
12 |
$156.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
34 |
33 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
47 |
46 |
$0.00 |