| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
15,542 |
14,207 |
$2.48M |
| 00003 |
Internal/system code - not a standard HCPCS code |
5,449 |
4,715 |
$981K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,779 |
5,617 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,649 |
2,376 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,323 |
2,290 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
996 |
978 |
$5K |
| 99215 |
Prolong outpt/office vis |
1,122 |
1,006 |
$2K |
| V2020 |
Frames, purchases |
2,412 |
2,369 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,963 |
1,928 |
$1K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
20 |
17 |
$662.61 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
308 |
297 |
$549.54 |
| 92015 |
Determination of refractive state |
3,349 |
3,311 |
$483.07 |
| 92341 |
|
249 |
245 |
$400.68 |
| 99000 |
|
530 |
488 |
$329.18 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
67 |
56 |
$260.89 |
| 90686 |
|
164 |
151 |
$103.20 |
| 92551 |
|
442 |
423 |
$73.48 |
| 90715 |
|
74 |
72 |
$50.51 |
| 99173 |
|
446 |
426 |
$31.46 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
29 |
28 |
$20.33 |
| 85018 |
|
583 |
559 |
$15.60 |
| 3077F |
|
267 |
253 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
330 |
188 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
1,978 |
1,849 |
$0.00 |
| 3050F |
|
286 |
249 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
267 |
253 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
63 |
60 |
$0.00 |
| 3078F |
|
1,179 |
1,123 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
33 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,708 |
872 |
$0.00 |
| 1036F |
|
2,973 |
2,544 |
$0.00 |
| 3074F |
|
1,548 |
1,461 |
$0.00 |
| 3008F |
|
4,091 |
3,508 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,422 |
1,430 |
$0.00 |
| 2001F |
|
4,090 |
3,507 |
$0.00 |
| 3079F |
|
848 |
807 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
367 |
243 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
2,061 |
1,928 |
$0.00 |
| 1111F |
|
3,573 |
3,112 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
115 |
109 |
$0.00 |
| 3075F |
|
305 |
301 |
$0.00 |
| 3080F |
|
100 |
95 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
396 |
311 |
$0.00 |
| 3049F |
|
596 |
512 |
$0.00 |
| 90656 |
|
44 |
43 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
36 |
18 |
$0.00 |
| 3048F |
|
805 |
698 |
$0.00 |
| 90651 |
|
38 |
38 |
$0.00 |
| 1034F |
|
27 |
19 |
$0.00 |