| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
735 |
718 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
308 |
302 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
54 |
52 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
562 |
401 |
$423.34 |
| 92015 |
Determination of refractive state |
489 |
475 |
$89.37 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
75 |
51 |
$15.66 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
590 |
575 |
$15.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
211 |
210 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
13 |
13 |
$0.00 |
| 92342 |
|
418 |
415 |
$0.00 |
| V2756 |
Eye glass case |
402 |
399 |
$0.00 |
| 2021F |
|
207 |
207 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
220 |
220 |
$0.00 |
| 92341 |
|
97 |
95 |
$0.00 |