| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,967 |
2,865 |
$157K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,770 |
1,716 |
$119K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,281 |
1,251 |
$116K |
| 92015 |
Determination of refractive state |
1,419 |
1,396 |
$11K |
| V2020 |
Frames, purchases |
2,699 |
1,504 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,523 |
811 |
$7K |
| 92133 |
|
89 |
80 |
$3K |
| S0516 |
Safety eyeglass frames |
194 |
191 |
$3K |
| 92341 |
|
71 |
68 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64 |
49 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,702 |
922 |
$3K |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
196 |
193 |
$2K |
| S9999 |
Sales tax |
390 |
383 |
$736.89 |
| 92083 |
|
12 |
12 |
$607.97 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
58 |
30 |
$540.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
43 |
24 |
$150.00 |