| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
9,144 |
8,405 |
$699K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,271 |
4,849 |
$461K |
| V2020 |
Frames, purchases |
10,462 |
9,363 |
$406K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,172 |
4,281 |
$219K |
| 92015 |
Determination of refractive state |
14,913 |
13,916 |
$206K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,121 |
2,627 |
$142K |
| V2755 |
U-v lens, per lens |
7,656 |
6,920 |
$79K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,318 |
1,080 |
$54K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
264 |
247 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
148 |
109 |
$9K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
108 |
53 |
$5K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
53 |
28 |
$2K |
| 92133 |
|
60 |
53 |
$1K |
| 92250 |
|
28 |
26 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$539.57 |
| G8732 |
No documentation of pain assessment, reason not given |
16 |
14 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
28 |
26 |
$0.00 |