| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
305 |
290 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
188 |
179 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
295 |
280 |
$564.36 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
14 |
$530.04 |
| 92015 |
Determination of refractive state |
348 |
325 |
$458.47 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
68 |
62 |
$85.26 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
72 |
72 |
$0.00 |
| 2022F |
|
72 |
72 |
$0.00 |
| 3072F |
|
69 |
69 |
$0.00 |
| 92342 |
|
74 |
74 |
$0.00 |
| V2756 |
Eye glass case |
74 |
74 |
$0.00 |