| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,954 |
3,832 |
$181K |
| V2025 |
Deluxe frame |
1,329 |
1,267 |
$88K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,141 |
1,110 |
$50K |
| V2020 |
Frames, purchases |
2,327 |
2,107 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,082 |
1,806 |
$33K |
| 92015 |
Determination of refractive state |
5,806 |
5,633 |
$18K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
103 |
95 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,186 |
1,164 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
956 |
776 |
$544.98 |
| 92133 |
|
42 |
40 |
$436.48 |
| 92341 |
|
94 |
91 |
$126.48 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
34 |
25 |
$54.67 |
| 92083 |
|
47 |
45 |
$40.28 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
12 |
$40.00 |
| V2756 |
Eye glass case |
251 |
250 |
$0.00 |
| 2019F |
|
237 |
236 |
$0.00 |
| 2023F |
|
570 |
548 |
$0.00 |
| 92342 |
|
252 |
251 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
405 |
405 |
$0.00 |
| 2021F |
|
138 |
138 |
$0.00 |
| 92134 |
|
12 |
12 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
26 |
25 |
$0.00 |