| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,318 |
2,293 |
$116K |
| V2020 |
Frames, purchases |
3,207 |
3,152 |
$98K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,751 |
1,724 |
$85K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,788 |
1,751 |
$35K |
| 92015 |
Determination of refractive state |
1,131 |
1,118 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,895 |
1,107 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
312 |
308 |
$8K |
| 92341 |
|
301 |
294 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
112 |
112 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
17 |
12 |
$861.28 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
65 |
40 |
$517.26 |
| 92250 |
|
74 |
74 |
$491.51 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
74 |
53 |
$353.34 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
461 |
447 |
$18.00 |
| V2756 |
Eye glass case |
54 |
54 |
$2.97 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
12 |
12 |
$0.00 |