| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,939 |
1,869 |
$87K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,010 |
1,936 |
$57K |
| 92015 |
Determination of refractive state |
3,039 |
2,952 |
$50K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
908 |
896 |
$39K |
| V2020 |
Frames, purchases |
2,301 |
2,211 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,616 |
1,548 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,086 |
1,069 |
$10K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
72 |
70 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
51 |
48 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
29 |
29 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
96 |
95 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
30 |
30 |
$838.35 |
| G8785 |
Blood pressure reading not documented, reason not given |
43 |
43 |
$0.00 |
| M1208 |
Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
47 |
46 |
$0.00 |