| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,467 |
5,306 |
$361K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,926 |
2,834 |
$260K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,007 |
3,918 |
$227K |
| 92015 |
Determination of refractive state |
7,133 |
6,909 |
$38K |
| 92341 |
|
503 |
496 |
$28K |
| V2020 |
Frames, purchases |
1,219 |
830 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
756 |
521 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
274 |
235 |
$3K |
| 92370 |
|
26 |
25 |
$698.90 |
| S0516 |
Safety eyeglass frames |
42 |
42 |
$671.16 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
56 |
56 |
$519.44 |
| S9999 |
Sales tax |
118 |
118 |
$287.25 |
| 2022F |
|
95 |
93 |
$0.00 |
| 2023F |
|
318 |
309 |
$0.00 |
| 3072F |
|
351 |
345 |
$0.00 |