| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,182 |
3,073 |
$368K |
| V2020 |
Frames, purchases |
5,316 |
4,956 |
$223K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,014 |
1,953 |
$189K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,154 |
3,859 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,305 |
4,115 |
$23K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
626 |
607 |
$21K |
| 92015 |
Determination of refractive state |
5,159 |
4,983 |
$13K |
| 92341 |
|
125 |
123 |
$855.00 |
| V2756 |
Eye glass case |
322 |
289 |
$0.00 |
| 92227 |
|
14 |
14 |
$0.00 |
| 92342 |
|
322 |
289 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
176 |
75 |
$0.00 |
| 3072F |
|
17 |
17 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
261 |
261 |
$0.00 |
| 2021F |
|
77 |
77 |
$0.00 |
| 2026F |
|
131 |
131 |
$0.00 |