| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
627 |
623 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
585 |
581 |
$16K |
| 92015 |
Determination of refractive state |
1,038 |
1,030 |
$16K |
| V2020 |
Frames, purchases |
524 |
517 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
188 |
186 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
282 |
277 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
254 |
254 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
56 |
56 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$121.22 |
| G8785 |
Blood pressure reading not documented, reason not given |
44 |
44 |
$0.00 |
| M1208 |
Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
12 |
12 |
$0.00 |