| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
267 |
254 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
137 |
124 |
$1K |
| V2020 |
Frames, purchases |
208 |
200 |
$825.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
224 |
221 |
$671.50 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$604.76 |
| 92015 |
Determination of refractive state |
164 |
162 |
$56.09 |
| 2019F |
|
44 |
44 |
$0.00 |
| V2756 |
Eye glass case |
32 |
32 |
$0.00 |
| 3072F |
|
29 |
29 |
$0.00 |
| 92342 |
|
32 |
32 |
$0.00 |
| 92227 |
|
27 |
27 |
$0.00 |
| V2025 |
Deluxe frame |
69 |
55 |
$0.00 |
| 2022F |
|
29 |
29 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
73 |
73 |
$0.00 |