| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,728 |
4,268 |
$328K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,422 |
2,953 |
$315K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,807 |
2,537 |
$150K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
981 |
893 |
$120K |
| 92015 |
Determination of refractive state |
6,181 |
5,330 |
$93K |
| 92250 |
|
1,672 |
1,298 |
$73K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,240 |
2,124 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,075 |
844 |
$68K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,119 |
1,035 |
$54K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
488 |
409 |
$54K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
620 |
316 |
$32K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
460 |
292 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
144 |
121 |
$7K |
| 92341 |
|
167 |
144 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
87 |
76 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
80 |
52 |
$3K |
| 92285 |
|
201 |
137 |
$2K |
| G9905 |
Patient not screened for tobacco use |
2,261 |
1,962 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
302 |
263 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
574 |
474 |
$0.00 |
| 1036F |
|
5,316 |
4,907 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
2,740 |
2,584 |
$0.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
618 |
589 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
13 |
12 |
$0.00 |
| V2702 |
Deluxe lens feature |
17 |
17 |
$0.00 |