| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
175 |
163 |
$6K |
| V2020 |
Frames, purchases |
193 |
146 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
180 |
135 |
$1K |
| 92015 |
Determination of refractive state |
366 |
353 |
$689.37 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$121.80 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
127 |
64 |
$0.00 |
| 3072F |
|
13 |
13 |
$0.00 |
| V2756 |
Eye glass case |
19 |
19 |
$0.00 |
| 92342 |
|
19 |
19 |
$0.00 |
| 2021F |
|
79 |
79 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
87 |
87 |
$0.00 |