| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,725 |
4,497 |
$307K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,942 |
4,690 |
$304K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,695 |
1,575 |
$138K |
| 92250 |
|
1,314 |
1,235 |
$57K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
124 |
114 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
36 |
33 |
$3K |
| 92370 |
|
132 |
119 |
$3K |
| 92015 |
Determination of refractive state |
293 |
236 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
37 |
$2K |
| V2020 |
Frames, purchases |
222 |
110 |
$832.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
104 |
51 |
$167.00 |
| S9999 |
Sales tax |
25 |
24 |
$38.19 |