| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,384 |
2,322 |
$209K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,029 |
2,944 |
$194K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,147 |
3,086 |
$167K |
| 92341 |
|
771 |
753 |
$43K |
| 92015 |
Determination of refractive state |
1,581 |
1,524 |
$24K |
| V2020 |
Frames, purchases |
2,509 |
1,405 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
181 |
176 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,146 |
635 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
104 |
94 |
$4K |
| S0516 |
Safety eyeglass frames |
193 |
192 |
$3K |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
212 |
211 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,120 |
569 |
$2K |
| 92002 |
|
18 |
18 |
$930.06 |
| S9999 |
Sales tax |
369 |
368 |
$770.61 |
| V2781 |
Progressive lens, per lens |
26 |
13 |
$585.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$341.88 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
24 |
12 |
$96.00 |
| 2023F |
|
40 |
39 |
$0.00 |
| 1036F |
|
236 |
217 |
$0.00 |
| G8397 |
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
160 |
153 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
17 |
16 |
$0.00 |
| 2022F |
|
12 |
12 |
$0.00 |
| 2027F |
|
29 |
29 |
$0.00 |