| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,295 |
1,222 |
$96K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
870 |
836 |
$61K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,374 |
1,118 |
$15K |
| V2020 |
Frames, purchases |
1,971 |
1,913 |
$7K |
| 92015 |
Determination of refractive state |
2,537 |
2,437 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,627 |
1,587 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
100 |
87 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
691 |
661 |
$731.52 |
| 92341 |
|
187 |
182 |
$573.57 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
119 |
90 |
$503.98 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
446 |
446 |
$0.00 |
| 2022F |
|
450 |
445 |
$0.00 |
| V2756 |
Eye glass case |
486 |
483 |
$0.00 |
| 92342 |
|
492 |
489 |
$0.00 |
| 2023F |
|
53 |
53 |
$0.00 |
| 3072F |
|
111 |
111 |
$0.00 |