| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,779 |
1,679 |
$80K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,061 |
1,031 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
695 |
670 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,740 |
1,629 |
$5K |
| 92015 |
Determination of refractive state |
2,083 |
2,007 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,123 |
846 |
$2K |
| 3072F |
|
206 |
205 |
$0.00 |
| V2756 |
Eye glass case |
563 |
535 |
$0.00 |
| 92342 |
|
563 |
535 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
242 |
128 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
24 |
14 |
$0.00 |
| 2022F |
|
520 |
520 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
539 |
539 |
$0.00 |
| 92341 |
|
27 |
27 |
$0.00 |