| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,750 |
1,644 |
$96K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
307 |
293 |
$22K |
| V2020 |
Frames, purchases |
626 |
578 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
102 |
93 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
57 |
56 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$302.61 |
| 92015 |
Determination of refractive state |
2,443 |
2,295 |
$150.45 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
13 |
13 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
13 |
13 |
$0.00 |