| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
956 |
906 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
116 |
114 |
$9K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
243 |
113 |
$8K |
| V2020 |
Frames, purchases |
292 |
274 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
299 |
148 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
290 |
276 |
$4K |
| 92015 |
Determination of refractive state |
406 |
391 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
70 |
54 |
$928.15 |
| 92133 |
|
34 |
31 |
$480.24 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$313.25 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$202.75 |
| 0517F |
|
14 |
13 |
$0.00 |
| G8756 |
No documentation of blood pressure measurement, reason not given |
46 |
42 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
15 |
15 |
$0.00 |
| 1036F |
|
29 |
15 |
$0.00 |