| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,124 |
3,056 |
$202K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,437 |
1,093 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
208 |
202 |
$15K |
| V2020 |
Frames, purchases |
2,262 |
2,049 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,796 |
1,623 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
84 |
69 |
$3K |
| 92015 |
Determination of refractive state |
2,819 |
2,769 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
287 |
163 |
$1K |
| 92341 |
|
137 |
135 |
$388.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
192 |
190 |
$145.72 |
| V2025 |
Deluxe frame |
38 |
34 |
$41.00 |
| 92342 |
|
549 |
548 |
$0.00 |
| V2756 |
Eye glass case |
549 |
548 |
$0.00 |
| 3072F |
|
134 |
133 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
622 |
622 |
$0.00 |
| 2022F |
|
617 |
609 |
$0.00 |