| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
813 |
798 |
$95K |
| V2020 |
Frames, purchases |
2,218 |
1,101 |
$84K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
506 |
497 |
$83K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,158 |
517 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,458 |
1,034 |
$7K |
| 92015 |
Determination of refractive state |
1,042 |
1,037 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
58 |
24 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
830 |
338 |
$425.00 |
| 3072F |
|
28 |
28 |
$0.00 |
| 92342 |
|
219 |
168 |
$0.00 |
| V2756 |
Eye glass case |
219 |
168 |
$0.00 |
| 2023F |
|
281 |
280 |
$0.00 |
| 2022F |
|
202 |
200 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
206 |
206 |
$0.00 |