| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,070 |
1,068 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
578 |
577 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
639 |
639 |
$40K |
| V2020 |
Frames, purchases |
1,237 |
1,220 |
$36K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
73 |
73 |
$2K |
| 92250 |
|
141 |
141 |
$2K |
| 92015 |
Determination of refractive state |
1,857 |
1,850 |
$37.25 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
94 |
89 |
$0.00 |
| G8732 |
No documentation of pain assessment, reason not given |
13 |
13 |
$0.00 |