| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
13,299 |
13,132 |
$241K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
4,436 |
4,407 |
$192K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,756 |
6,684 |
$130K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,984 |
1,974 |
$86K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,428 |
1,422 |
$77K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,404 |
3,359 |
$71K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,792 |
1,768 |
$30K |
| 92002 |
|
437 |
433 |
$25K |
| 92015 |
Determination of refractive state |
2,716 |
2,674 |
$25K |
| V2750 |
Anti-reflective coating, per lens |
1,163 |
1,146 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
713 |
708 |
$14K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
118 |
116 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
104 |
102 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
148 |
145 |
$2K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
68 |
68 |
$2K |
| V2799 |
Vision item or service, miscellaneous |
65 |
65 |
$180.13 |