| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,747 |
2,587 |
$173K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,025 |
2,761 |
$155K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,456 |
1,367 |
$124K |
| 92015 |
Determination of refractive state |
2,421 |
2,280 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
360 |
278 |
$13K |
| V2020 |
Frames, purchases |
945 |
509 |
$5K |
| 92370 |
|
98 |
95 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
283 |
233 |
$2K |
| S0516 |
Safety eyeglass frames |
31 |
31 |
$495.38 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
31 |
31 |
$295.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
32 |
24 |
$258.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
38 |
28 |
$86.00 |
| S9999 |
Sales tax |
31 |
31 |
$48.54 |