| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,856 |
3,749 |
$516K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,973 |
2,914 |
$390K |
| V2020 |
Frames, purchases |
9,464 |
6,941 |
$251K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
9,014 |
6,626 |
$56K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,811 |
3,682 |
$21K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
262 |
172 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,256 |
1,427 |
$2K |
| 92015 |
Determination of refractive state |
1,614 |
1,591 |
$2K |
| 92341 |
|
368 |
289 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
37 |
37 |
$231.90 |
| V2025 |
Deluxe frame |
333 |
268 |
$71.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
87 |
70 |
$56.64 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
267 |
208 |
$30.36 |
| 2022F |
|
815 |
815 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
1,197 |
1,197 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
28 |
28 |
$0.00 |
| 2024F |
|
19 |
19 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
62 |
47 |
$0.00 |
| 2023F |
|
1,400 |
1,399 |
$0.00 |
| V2756 |
Eye glass case |
1,627 |
1,176 |
$0.00 |
| 92342 |
|
1,627 |
1,176 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
127 |
48 |
$0.00 |