| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,791 |
1,785 |
$57K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
897 |
897 |
$41K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
708 |
708 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,634 |
1,626 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,129 |
1,128 |
$18K |
| 92341 |
|
221 |
221 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
331 |
330 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
192 |
192 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
78 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
162 |
162 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
111 |
111 |
$2K |