| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,457 |
4,378 |
$271K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,020 |
1,977 |
$134K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
635 |
631 |
$58K |
| 92341 |
|
236 |
232 |
$13K |
| 92370 |
|
283 |
278 |
$8K |
| V2020 |
Frames, purchases |
832 |
711 |
$2K |
| 92015 |
Determination of refractive state |
2,390 |
2,333 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
229 |
200 |
$300.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
268 |
226 |
$172.75 |
| 1036F |
|
978 |
943 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
14 |
14 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
71 |
68 |
$0.00 |