| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,364 |
1,343 |
$54K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
734 |
723 |
$45K |
| 92250 |
|
15 |
15 |
$343.07 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
14 |
$257.58 |
| S0516 |
Safety eyeglass frames |
13 |
13 |
$207.74 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
13 |
13 |
$125.62 |
| V2020 |
Frames, purchases |
26 |
13 |
$97.50 |
| S9999 |
Sales tax |
13 |
13 |
$20.37 |