| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
10,705 |
10,285 |
$310K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,287 |
4,454 |
$285K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
3,123 |
2,299 |
$280K |
| 92341 |
|
7,680 |
7,478 |
$224K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,193 |
3,857 |
$189K |
| V2025 |
Deluxe frame |
6,275 |
4,409 |
$161K |
| V2599 |
Contact lens, other type |
109 |
68 |
$47K |
| V2020 |
Frames, purchases |
6,283 |
5,390 |
$43K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
557 |
557 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
496 |
394 |
$22K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,375 |
1,235 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,172 |
1,993 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
310 |
296 |
$14K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
235 |
222 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,257 |
2,063 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26 |
22 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
359 |
344 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
199 |
191 |
$923.30 |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
26 |
25 |
$351.96 |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
27 |
26 |
$163.04 |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
40 |
40 |
$159.21 |
| S0581 |
Nonstandard lens (list this code in addition to the basic code for the lens) |
165 |
165 |
$0.00 |
| 92002 |
|
253 |
250 |
$0.00 |