| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,950 |
2,824 |
$251K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,700 |
3,409 |
$214K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,673 |
2,450 |
$157K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
857 |
745 |
$33K |
| 92015 |
Determination of refractive state |
5,260 |
4,878 |
$28K |
| 92341 |
|
246 |
214 |
$12K |
| 92065 |
|
138 |
60 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
67 |
67 |
$4K |
| V2020 |
Frames, purchases |
412 |
236 |
$1K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
19 |
17 |
$595.10 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
26 |
13 |
$540.25 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$466.20 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
27 |
13 |
$261.25 |
| S0516 |
Safety eyeglass frames |
15 |
15 |
$239.70 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
15 |
15 |
$131.28 |
| S9999 |
Sales tax |
57 |
56 |
$126.81 |