| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,882 |
1,760 |
$215K |
| V2020 |
Frames, purchases |
2,728 |
2,535 |
$132K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
799 |
757 |
$74K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,131 |
1,060 |
$60K |
| 92015 |
Determination of refractive state |
3,395 |
3,163 |
$51K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
613 |
583 |
$6K |
| 92250 |
|
124 |
109 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
41 |
40 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21 |
13 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
40 |
29 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
26 |
$1K |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
15 |
12 |
$0.00 |