| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,286 |
2,283 |
$109K |
| V2020 |
Frames, purchases |
3,930 |
3,922 |
$97K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,754 |
1,753 |
$79K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,445 |
3,439 |
$65K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,026 |
2,023 |
$25K |
| 92341 |
|
695 |
694 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
242 |
242 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
49 |
41 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
90 |
88 |
$2K |
| 92250 |
|
55 |
55 |
$1K |
| 92015 |
Determination of refractive state |
126 |
126 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
39 |
39 |
$572.78 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
45 |
45 |
$0.00 |