| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,665 |
4,125 |
$467K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,337 |
2,585 |
$270K |
| V2020 |
Frames, purchases |
7,493 |
6,330 |
$41K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,748 |
5,734 |
$35K |
| 92015 |
Determination of refractive state |
6,836 |
5,611 |
$13K |
| 92341 |
|
568 |
429 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,757 |
3,945 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,453 |
4,715 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
89 |
79 |
$945.71 |
| 92250 |
|
709 |
609 |
$718.71 |
| V2755 |
U-v lens, per lens |
4,717 |
4,140 |
$264.00 |
| V2025 |
Deluxe frame |
87 |
87 |
$132.18 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,342 |
1,207 |
$66.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
201 |
143 |
$28.00 |
| V2756 |
Eye glass case |
30 |
25 |
$0.00 |
| 92342 |
|
12 |
12 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
154 |
133 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
14 |
14 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
90 |
87 |
$0.00 |