| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,981 |
1,902 |
$205K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,199 |
1,167 |
$108K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,285 |
2,013 |
$15K |
| V2020 |
Frames, purchases |
1,999 |
1,915 |
$11K |
| 92015 |
Determination of refractive state |
2,313 |
2,222 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,063 |
2,906 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
353 |
319 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
50 |
50 |
$831.95 |
| 2022F |
|
358 |
358 |
$0.00 |
| V2025 |
Deluxe frame |
1,175 |
1,022 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
494 |
494 |
$0.00 |
| 92342 |
|
470 |
462 |
$0.00 |
| V2756 |
Eye glass case |
448 |
445 |
$0.00 |
| 3072F |
|
194 |
194 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
204 |
102 |
$0.00 |