| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
669 |
639 |
$43K |
| V2025 |
Deluxe frame |
378 |
345 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
299 |
292 |
$12K |
| V2020 |
Frames, purchases |
315 |
308 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
72 |
70 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
479 |
435 |
$2K |
| 92002 |
|
15 |
15 |
$525.00 |
| 92015 |
Determination of refractive state |
1,421 |
1,376 |
$293.40 |
| V2799 |
Vision item or service, miscellaneous |
403 |
355 |
$139.00 |
| G8397 |
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
136 |
111 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
174 |
174 |
$0.00 |
| 2022F |
|
172 |
172 |
$0.00 |
| 92341 |
|
37 |
37 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
123 |
123 |
$0.00 |