| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
313 |
309 |
$9K |
| 92250 |
|
69 |
68 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
94 |
94 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
244 |
236 |
$2K |
| 92015 |
Determination of refractive state |
351 |
343 |
$307.01 |
| V2020 |
Frames, purchases |
197 |
192 |
$243.62 |
| V2756 |
Eye glass case |
67 |
67 |
$0.00 |
| 92342 |
|
68 |
68 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
70 |
47 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
12 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
158 |
158 |
$0.00 |