| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,863 |
6,817 |
$157K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
3,328 |
3,317 |
$119K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,094 |
3,082 |
$111K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,866 |
5,822 |
$93K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,914 |
2,869 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,643 |
2,619 |
$25K |
| 92341 |
|
843 |
840 |
$15K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
452 |
434 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,070 |
1,065 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
229 |
226 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
77 |
69 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
28 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
31 |
31 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
62 |
60 |
$2K |
| 92015 |
Determination of refractive state |
75 |
75 |
$565.59 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
70 |
70 |
$507.57 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
27 |
27 |
$126.75 |
| V2744 |
Tint, photochromatic, per lens |
62 |
60 |
$37.62 |
| V2781 |
Progressive lens, per lens |
38 |
37 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
202 |
198 |
$0.00 |