| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,609 |
4,822 |
$58K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,491 |
4,689 |
$27K |
| V2020 |
Frames, purchases |
4,785 |
3,931 |
$11K |
| V2025 |
Deluxe frame |
480 |
466 |
$185.57 |
| 92015 |
Determination of refractive state |
12,999 |
11,126 |
$15.77 |
| S3000 |
Diabetic indicator; retinal eye exam, dilated, bilateral |
127 |
78 |
$9.24 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
140 |
60 |
$0.77 |
| 2022F |
|
7,552 |
6,187 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
7,687 |
6,363 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
331 |
239 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,239 |
1,132 |
$0.00 |
| 92341 |
|
593 |
573 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
281 |
126 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
40 |
12 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
44 |
27 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,695 |
1,274 |
$0.00 |
| 92342 |
|
1,433 |
1,251 |
$0.00 |
| 3072F |
|
688 |
575 |
$0.00 |
| V2756 |
Eye glass case |
1,368 |
1,186 |
$0.00 |
| V2781 |
Progressive lens, per lens |
13 |
13 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,792 |
729 |
$0.00 |
| 2023F |
|
130 |
128 |
$0.00 |
| 2019F |
|
871 |
704 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
266 |
255 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
387 |
367 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
46 |
44 |
$0.00 |
| 92227 |
|
16 |
16 |
$0.00 |
| 92310 |
|
38 |
25 |
$0.00 |