| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,511 |
1,484 |
$34K |
| V2020 |
Frames, purchases |
1,168 |
1,143 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
243 |
230 |
$16K |
| 92015 |
Determination of refractive state |
1,465 |
1,395 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
223 |
211 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
130 |
128 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
316 |
316 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
66 |
63 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
276 |
267 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
40 |
40 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
12 |
$617.43 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
52 |
52 |
$348.12 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
66 |
66 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
15 |
15 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
162 |
150 |
$0.00 |