| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,344 |
1,342 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
206 |
206 |
$18K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
448 |
447 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
243 |
242 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
241 |
225 |
$10K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
149 |
149 |
$6K |
| V2020 |
Frames, purchases |
94 |
94 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
53 |
53 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$180.00 |
| 76514 |
|
13 |
12 |
$83.22 |