| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
519 |
519 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
359 |
358 |
$2K |
| V2020 |
Frames, purchases |
881 |
847 |
$251.38 |
| 92015 |
Determination of refractive state |
838 |
836 |
$191.54 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
804 |
401 |
$27.18 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
771 |
738 |
$0.00 |
| 92341 |
|
54 |
53 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
820 |
820 |
$0.00 |
| 2022F |
|
340 |
338 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
279 |
133 |
$0.00 |
| 92342 |
|
859 |
828 |
$0.00 |
| 3072F |
|
148 |
148 |
$0.00 |
| V2756 |
Eye glass case |
859 |
828 |
$0.00 |