| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,774 |
1,675 |
$63K |
| V2020 |
Frames, purchases |
2,205 |
2,026 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,110 |
1,944 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
285 |
254 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
330 |
321 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,416 |
1,149 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
418 |
337 |
$2K |
| 92341 |
|
141 |
137 |
$2K |
| 92015 |
Determination of refractive state |
2,141 |
2,014 |
$225.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
74 |
65 |
$119.36 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
64 |
57 |
$110.66 |
| V2025 |
Deluxe frame |
110 |
103 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
359 |
359 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$0.00 |
| V2756 |
Eye glass case |
280 |
280 |
$0.00 |
| 92342 |
|
280 |
280 |
$0.00 |
| 2019F |
|
351 |
351 |
$0.00 |