| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
67 |
67 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
45 |
45 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
68 |
61 |
$47.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
48 |
42 |
$0.00 |
| 3072F |
|
22 |
22 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |
| 92015 |
Determination of refractive state |
148 |
141 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
65 |
65 |
$0.00 |
| 2022F |
|
66 |
66 |
$0.00 |
| V2020 |
Frames, purchases |
85 |
78 |
$0.00 |