| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
148 |
145 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
307 |
294 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
145 |
126 |
$3K |
| V2020 |
Frames, purchases |
492 |
420 |
$499.75 |
| V2025 |
Deluxe frame |
41 |
27 |
$489.00 |
| 92341 |
|
19 |
13 |
$255.00 |
| 92015 |
Determination of refractive state |
416 |
384 |
$96.63 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
53 |
41 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
45 |
43 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
12 |
12 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
21 |
13 |
$0.00 |
| 2021F |
|
12 |
12 |
$0.00 |