| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,306 |
5,178 |
$346K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,908 |
3,815 |
$346K |
| V2020 |
Frames, purchases |
7,652 |
6,980 |
$187K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,846 |
5,762 |
$171K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,729 |
5,484 |
$115K |
| 92341 |
|
1,137 |
1,125 |
$30K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,004 |
3,710 |
$28K |
| 92015 |
Determination of refractive state |
1,983 |
1,846 |
$24K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
767 |
738 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
495 |
468 |
$19K |
| V2760 |
Scratch resistant coating, per lens |
3,381 |
3,314 |
$7K |
| 92370 |
|
178 |
175 |
$5K |
| 92133 |
|
114 |
113 |
$4K |
| 92002 |
|
72 |
72 |
$4K |
| 92250 |
|
84 |
80 |
$3K |
| 92020 |
|
134 |
131 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
13 |
$1K |
| 76514 |
|
100 |
98 |
$801.59 |
| S0516 |
Safety eyeglass frames |
47 |
47 |
$751.06 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
111 |
58 |
$528.00 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
50 |
50 |
$446.06 |
| S9999 |
Sales tax |
149 |
148 |
$214.29 |