| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
8,269 |
8,237 |
$327K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,558 |
2,429 |
$174K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,754 |
1,660 |
$93K |
| V2020 |
Frames, purchases |
1,991 |
1,963 |
$59K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,139 |
3,102 |
$46K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
575 |
575 |
$44K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,943 |
1,908 |
$35K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
476 |
471 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
455 |
420 |
$18K |
| 92015 |
Determination of refractive state |
1,469 |
1,438 |
$14K |
| 92250 |
|
295 |
277 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
164 |
160 |
$436.80 |
| V2750 |
Anti-reflective coating, per lens |
14 |
14 |
$0.00 |