| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
547 |
521 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
386 |
369 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
425 |
401 |
$4K |
| V2020 |
Frames, purchases |
724 |
680 |
$3K |
| 92341 |
|
67 |
64 |
$593.76 |
| 92015 |
Determination of refractive state |
553 |
545 |
$310.01 |
| 2022F |
|
256 |
255 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
255 |
255 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
89 |
59 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
169 |
131 |
$0.00 |
| 3072F |
|
120 |
120 |
$0.00 |
| 92342 |
|
142 |
142 |
$0.00 |
| V2756 |
Eye glass case |
141 |
141 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
52 |
51 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18 |
15 |
$0.00 |