| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,840 |
1,773 |
$136K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
468 |
455 |
$35K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
119 |
108 |
$9K |
| V2020 |
Frames, purchases |
2,321 |
2,241 |
$5K |
| 92015 |
Determination of refractive state |
2,488 |
2,410 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,916 |
1,859 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,874 |
1,764 |
$3K |
| 92341 |
|
174 |
169 |
$401.32 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$10.00 |
| 92342 |
|
220 |
220 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$0.00 |
| V2756 |
Eye glass case |
220 |
220 |
$0.00 |
| 3072F |
|
25 |
25 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
218 |
218 |
$0.00 |