| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Frames, purchases |
9,363 |
9,339 |
$250K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
3,944 |
3,943 |
$157K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,786 |
3,786 |
$153K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,975 |
7,938 |
$134K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,072 |
5,059 |
$65K |
| 92341 |
|
1,480 |
1,478 |
$29K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,230 |
1,228 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,460 |
1,455 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
266 |
249 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
714 |
712 |
$9K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
556 |
556 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
285 |
254 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
358 |
358 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
52 |
52 |
$3K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
140 |
140 |
$2K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
101 |
100 |
$2K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
125 |
125 |
$1K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
101 |
101 |
$1K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
92 |
92 |
$1K |
| 92083 |
|
28 |
28 |
$952.02 |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
42 |
42 |
$648.45 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
15 |
$593.46 |
| 92133 |
|
28 |
28 |
$561.60 |
| V2112 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens |
13 |
13 |
$180.47 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$0.00 |