| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
883 |
848 |
$57K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
180 |
169 |
$10K |
| V2020 |
Frames, purchases |
345 |
339 |
$10K |
| 92015 |
Determination of refractive state |
856 |
833 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
44 |
44 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
252 |
244 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
232 |
227 |
$1K |
| V2025 |
Deluxe frame |
64 |
58 |
$288.00 |
| 2022F |
|
164 |
158 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
18 |
18 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
15 |
$0.00 |