| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
299 |
295 |
$32K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
291 |
290 |
$29K |
| 92015 |
Determination of refractive state |
637 |
632 |
$685.00 |
| V2020 |
Frames, purchases |
576 |
572 |
$240.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
450 |
381 |
$35.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
491 |
489 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
137 |
137 |
$0.00 |
| 92341 |
|
12 |
12 |
$0.00 |
| V2755 |
U-v lens, per lens |
288 |
284 |
$0.00 |
| 92342 |
|
143 |
143 |
$0.00 |
| V2756 |
Eye glass case |
143 |
143 |
$0.00 |