| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
943 |
929 |
$43K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,188 |
1,163 |
$33K |
| 92015 |
Determination of refractive state |
1,807 |
1,779 |
$30K |
| V2020 |
Frames, purchases |
1,023 |
999 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
419 |
416 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
645 |
632 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
195 |
195 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
16 |
16 |
$743.20 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$540.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
12 |
12 |
$533.40 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
12 |
$216.86 |
| G8785 |
Blood pressure reading not documented, reason not given |
63 |
60 |
$0.00 |
| M1208 |
Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
13 |
13 |
$0.00 |