| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
893 |
811 |
$42K |
| V2020 |
Frames, purchases |
1,140 |
972 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,018 |
773 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
494 |
394 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
199 |
179 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,247 |
1,063 |
$3K |
| 92015 |
Determination of refractive state |
1,705 |
1,540 |
$2K |
| V2756 |
Eye glass case |
194 |
193 |
$0.00 |
| 92342 |
|
228 |
227 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$0.00 |
| 2022F |
|
141 |
136 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
231 |
231 |
$0.00 |
| V2025 |
Deluxe frame |
13 |
13 |
$0.00 |