| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,371 |
2,360 |
$103K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,424 |
4,356 |
$82K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,685 |
1,660 |
$74K |
| V2020 |
Frames, purchases |
2,220 |
2,219 |
$56K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,174 |
1,113 |
$52K |
| 92341 |
|
1,210 |
1,194 |
$26K |
| 92015 |
Determination of refractive state |
1,501 |
1,468 |
$17K |
| 92002 |
|
278 |
276 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,130 |
1,128 |
$11K |
| 92250 |
|
563 |
562 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
118 |
112 |
$5K |
| 92083 |
|
71 |
66 |
$2K |
| 92133 |
|
76 |
76 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14 |
12 |
$859.25 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
50 |
50 |
$494.40 |
| 92225 |
|
21 |
12 |
$352.26 |
| 1036F |
|
173 |
173 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
173 |
173 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
345 |
325 |
$0.00 |
| G9905 |
Patient not screened for tobacco use |
246 |
229 |
$0.00 |