| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,451 |
5,181 |
$253K |
| V2020 |
Frames, purchases |
5,813 |
5,383 |
$136K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,393 |
1,344 |
$60K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
859 |
747 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,506 |
5,130 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,755 |
1,513 |
$12K |
| 92133 |
|
251 |
223 |
$12K |
| 92015 |
Determination of refractive state |
6,788 |
6,449 |
$11K |
| 92083 |
|
337 |
294 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,308 |
2,798 |
$5K |
| 92341 |
|
266 |
234 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
221 |
173 |
$679.97 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
300 |
282 |
$260.90 |
| 92134 |
|
14 |
14 |
$236.49 |
| 76514 |
|
33 |
32 |
$51.50 |
| 92342 |
|
615 |
608 |
$30.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
42 |
42 |
$27.18 |
| 2019F |
|
629 |
626 |
$0.00 |
| V2756 |
Eye glass case |
613 |
606 |
$0.00 |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
13 |
13 |
$0.00 |
| V2025 |
Deluxe frame |
85 |
83 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
649 |
647 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
50 |
45 |
$0.00 |
| 2022F |
|
18 |
18 |
$0.00 |