| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,591 |
6,557 |
$156K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,069 |
3,066 |
$106K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,963 |
2,960 |
$101K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,714 |
5,682 |
$87K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,917 |
3,881 |
$46K |
| 92341 |
|
721 |
720 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,354 |
1,345 |
$13K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
435 |
426 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
227 |
227 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
83 |
80 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$484.92 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
254 |
254 |
$0.00 |