| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
890 |
865 |
$41K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
443 |
431 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
178 |
177 |
$8K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
77 |
76 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
128 |
116 |
$4K |
| 92015 |
Determination of refractive state |
319 |
319 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
59 |
58 |
$3K |
| V2020 |
Frames, purchases |
287 |
287 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
278 |
278 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
118 |
118 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$197.00 |