| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14,425 |
11,913 |
$766K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,709 |
4,732 |
$372K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,760 |
5,388 |
$183K |
| V2020 |
Frames, purchases |
13,475 |
9,750 |
$144K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,769 |
3,081 |
$105K |
| 92015 |
Determination of refractive state |
16,759 |
13,488 |
$94K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,483 |
2,699 |
$94K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,000 |
3,754 |
$50K |
| 92250 |
|
1,346 |
1,189 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
737 |
707 |
$9K |
| V2799 |
Vision item or service, miscellaneous |
279 |
272 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
37 |
26 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
13 |
$1K |
| V2025 |
Deluxe frame |
33 |
24 |
$903.23 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
129 |
95 |
$127.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
286 |
217 |
$0.00 |
| 2026F |
|
425 |
271 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
41 |
27 |
$0.00 |
| 2025F |
|
31 |
30 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
63 |
55 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
13 |
12 |
$0.00 |
| G8732 |
No documentation of pain assessment, reason not given |
204 |
146 |
$0.00 |
| 3072F |
|
115 |
108 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
14 |
12 |
$0.00 |
| 1036F |
|
17 |
12 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
213 |
150 |
$0.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
14 |
14 |
$0.00 |