| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
9,058 |
8,657 |
$576K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
8,884 |
8,135 |
$501K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,976 |
4,805 |
$434K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,270 |
1,862 |
$84K |
| 92015 |
Determination of refractive state |
12,333 |
11,606 |
$58K |
| V2020 |
Frames, purchases |
1,550 |
1,255 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
634 |
544 |
$11K |
| 92341 |
|
127 |
116 |
$7K |
| 92083 |
|
62 |
55 |
$3K |
| 92370 |
|
85 |
82 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
499 |
385 |
$2K |
| 92020 |
|
86 |
78 |
$1K |
| S0516 |
Safety eyeglass frames |
67 |
66 |
$1K |
| 92310 |
|
18 |
17 |
$976.36 |
| 92250 |
|
30 |
28 |
$948.23 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
68 |
67 |
$625.30 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
37 |
26 |
$84.00 |
| S9999 |
Sales tax |
34 |
34 |
$49.14 |