| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,173 |
2,160 |
$98K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
678 |
670 |
$32K |
| V2020 |
Frames, purchases |
742 |
737 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
683 |
679 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
771 |
767 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
13 |
$613.65 |
| 92015 |
Determination of refractive state |
2,486 |
2,450 |
$601.74 |
| 1036F |
|
186 |
175 |
$475.00 |
| 92250 |
|
12 |
12 |
$158.85 |
| 99199 |
Unlisted special service, procedure or report |
1,355 |
1,355 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
120 |
103 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
220 |
201 |
$0.00 |