| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,788 |
2,532 |
$215K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,414 |
1,305 |
$138K |
| V2020 |
Frames, purchases |
2,672 |
2,548 |
$94K |
| 92015 |
Determination of refractive state |
4,143 |
3,829 |
$53K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,063 |
1,029 |
$37K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
616 |
585 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
478 |
386 |
$22K |
| 92133 |
|
473 |
394 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
242 |
218 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
389 |
373 |
$7K |
| 92250 |
|
103 |
88 |
$3K |
| 92083 |
|
77 |
67 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$851.97 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$820.18 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$729.62 |
| 92134 |
|
15 |
14 |
$332.65 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
28 |
24 |
$0.00 |