| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
660 |
660 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
545 |
545 |
$23K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
56 |
54 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
36 |
36 |
$2K |
| V2020 |
Frames, purchases |
56 |
56 |
$1K |
| 92015 |
Determination of refractive state |
1,272 |
1,272 |
$900.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$589.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
12 |
12 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
44 |
44 |
$0.00 |