| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,240 |
1,214 |
$84K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,854 |
1,797 |
$51K |
| V2020 |
Frames, purchases |
1,921 |
1,764 |
$50K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
441 |
436 |
$41K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,166 |
1,084 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,627 |
1,460 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
199 |
191 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
1,067 |
1,018 |
$2K |
| 92015 |
Determination of refractive state |
261 |
261 |
$424.62 |
| S9999 |
Sales tax |
12 |
12 |
$18.00 |
| G8732 |
No documentation of pain assessment, reason not given |
78 |
74 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
12 |
12 |
$0.00 |