| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
648 |
604 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
371 |
366 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
223 |
219 |
$6K |
| 92341 |
|
160 |
152 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
138 |
87 |
$904.62 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
90 |
55 |
$777.44 |
| V2020 |
Frames, purchases |
806 |
749 |
$186.20 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
20 |
14 |
$107.18 |
| V2756 |
Eye glass case |
90 |
90 |
$0.00 |
| 92342 |
|
90 |
90 |
$0.00 |
| 2019F |
|
129 |
129 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
130 |
130 |
$0.00 |
| 92015 |
Determination of refractive state |
341 |
336 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
20 |
15 |
$0.00 |