| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,855 |
2,775 |
$183K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,731 |
2,645 |
$166K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,871 |
1,801 |
$163K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
700 |
619 |
$32K |
| 92015 |
Determination of refractive state |
1,615 |
1,504 |
$28K |
| 92341 |
|
420 |
405 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
686 |
571 |
$23K |
| V2020 |
Frames, purchases |
539 |
403 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
104 |
75 |
$2K |
| 92083 |
|
16 |
16 |
$744.99 |
| 92250 |
|
14 |
14 |
$640.73 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
53 |
40 |
$292.25 |
| S0516 |
Safety eyeglass frames |
12 |
12 |
$191.76 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
12 |
12 |
$107.28 |
| S9999 |
Sales tax |
12 |
12 |
$27.06 |
| 1036F |
|
16 |
13 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
35 |
31 |
$0.00 |