| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,807 |
3,707 |
$275K |
| V2025 |
Deluxe frame |
3,125 |
3,112 |
$140K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,075 |
3,028 |
$139K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
970 |
924 |
$90K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,196 |
3,164 |
$82K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,079 |
3,049 |
$57K |
| V2020 |
Frames, purchases |
2,405 |
2,366 |
$38K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
665 |
661 |
$30K |
| V2750 |
Anti-reflective coating, per lens |
354 |
351 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
538 |
532 |
$10K |
| 92060 |
|
169 |
164 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
221 |
209 |
$5K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
121 |
116 |
$3K |
| 92015 |
Determination of refractive state |
272 |
271 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$630.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
14 |
$344.40 |
| V2744 |
Tint, photochromatic, per lens |
15 |
15 |
$305.84 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$300.09 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$209.85 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$174.18 |
| 1036F |
|
268 |
263 |
$0.00 |
| 83861 |
|
30 |
16 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
1,063 |
1,027 |
$0.00 |
| 2027F |
|
14 |
12 |
$0.00 |