| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,727 |
1,567 |
$91K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,022 |
931 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
714 |
677 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
744 |
594 |
$427.70 |
| 92015 |
Determination of refractive state |
1,962 |
1,819 |
$336.54 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
611 |
498 |
$325.07 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,523 |
1,378 |
$75.00 |
| 92341 |
|
17 |
12 |
$15.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
40 |
38 |
$5.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
234 |
234 |
$0.00 |
| 2022F |
|
193 |
193 |
$0.00 |
| 92342 |
|
181 |
181 |
$0.00 |
| 3072F |
|
192 |
192 |
$0.00 |
| V2756 |
Eye glass case |
181 |
181 |
$0.00 |