| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,808 |
2,692 |
$165K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,520 |
2,390 |
$159K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,490 |
1,421 |
$129K |
| 92015 |
Determination of refractive state |
3,631 |
3,441 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
240 |
207 |
$10K |
| 92370 |
|
85 |
76 |
$2K |
| 92341 |
|
29 |
29 |
$2K |
| V2020 |
Frames, purchases |
385 |
290 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
44 |
43 |
$191.10 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
12 |
12 |
$110.10 |
| S9999 |
Sales tax |
25 |
25 |
$35.16 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$0.00 |