| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
350 |
346 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
289 |
279 |
$15K |
| V2020 |
Frames, purchases |
601 |
585 |
$5K |
| V2025 |
Deluxe frame |
151 |
147 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
484 |
468 |
$1K |
| 92341 |
|
52 |
52 |
$229.80 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
288 |
255 |
$222.60 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
86 |
77 |
$120.06 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
89 |
74 |
$58.66 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
306 |
304 |
$8.00 |
| 92015 |
Determination of refractive state |
523 |
515 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
175 |
175 |
$0.00 |
| 2022F |
|
177 |
176 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
15 |
15 |
$0.00 |
| S3000 |
Diabetic indicator; retinal eye exam, dilated, bilateral |
15 |
15 |
$0.00 |
| 92002 |
|
120 |
120 |
$0.00 |
| 3072F |
|
13 |
13 |
$0.00 |
| 92227 |
|
15 |
15 |
$0.00 |