| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
7,086 |
6,917 |
$209K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,772 |
3,706 |
$180K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,285 |
3,205 |
$173K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
3,613 |
3,562 |
$166K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,062 |
6,922 |
$134K |
| 92341 |
|
2,665 |
2,620 |
$59K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,266 |
3,203 |
$52K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
658 |
633 |
$46K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,501 |
2,468 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
857 |
766 |
$36K |
| V2025 |
Deluxe frame |
595 |
593 |
$32K |
| 92015 |
Determination of refractive state |
3,491 |
3,410 |
$31K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
857 |
830 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
306 |
298 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
133 |
130 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
809 |
805 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
54 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
115 |
115 |
$2K |
| 92133 |
|
68 |
68 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
28 |
27 |
$418.49 |
| 2022F |
|
13 |
13 |
$0.00 |