| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
942 |
847 |
$35K |
| V2020 |
Frames, purchases |
1,843 |
1,644 |
$29K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
573 |
515 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
379 |
320 |
$20K |
| 92015 |
Determination of refractive state |
1,186 |
1,001 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
841 |
762 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
356 |
298 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
470 |
350 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
364 |
317 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
47 |
32 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
81 |
77 |
$820.12 |
| 92133 |
|
14 |
12 |
$273.88 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
13 |
$207.60 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
1,306 |
1,132 |
$46.18 |
| G9905 |
Patient not screened for tobacco use |
843 |
723 |
$0.03 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
19 |
15 |
$0.00 |
| 1036F |
|
20 |
16 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
48 |
37 |
$0.00 |