| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,452 |
4,279 |
$135K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,691 |
1,643 |
$83K |
| 92370 |
|
4,559 |
4,368 |
$78K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,752 |
3,599 |
$72K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
906 |
889 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,611 |
2,523 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
199 |
199 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,271 |
1,215 |
$12K |
| 92341 |
|
401 |
392 |
$9K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
350 |
346 |
$5K |
| 92283 |
|
190 |
170 |
$4K |
| 92015 |
Determination of refractive state |
259 |
258 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
32 |
32 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
13 |
$133.44 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
16 |
16 |
$0.00 |