| Code | Description | Claims | Beneficiaries | Total Paid |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
86 |
86 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
27 |
27 |
$3K |
| 92015 |
Determination of refractive state |
114 |
114 |
$2K |
| 92250 |
|
12 |
12 |
$382.20 |
| 1036F |
|
86 |
86 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
82 |
82 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
20 |
20 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
148 |
146 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
136 |
134 |
$0.00 |