| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,243 |
1,155 |
$106K |
| V2020 |
Frames, purchases |
1,537 |
1,431 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
497 |
472 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
33 |
30 |
$2K |
| 92015 |
Determination of refractive state |
1,813 |
1,697 |
$322.12 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,319 |
1,225 |
$216.10 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
145 |
125 |
$169.49 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
27 |
$138.71 |
| 92341 |
|
30 |
27 |
$19.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
856 |
724 |
$12.18 |
| 2022F |
|
105 |
105 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
125 |
125 |
$0.00 |
| V2756 |
Eye glass case |
57 |
57 |
$0.00 |
| 3072F |
|
68 |
68 |
$0.00 |
| 92342 |
|
57 |
57 |
$0.00 |