| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
5,367 |
4,937 |
$185K |
| 92250 |
|
4,147 |
3,901 |
$155K |
| V2020 |
Frames, purchases |
3,962 |
3,789 |
$113K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,242 |
2,034 |
$112K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,506 |
3,350 |
$73K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,921 |
2,240 |
$68K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
4,105 |
2,053 |
$60K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,652 |
1,440 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
727 |
681 |
$45K |
| 83861 |
|
3,060 |
1,425 |
$38K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
454 |
425 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
474 |
444 |
$23K |
| 93886 |
|
163 |
160 |
$19K |
| 95930 |
|
285 |
264 |
$14K |
| 93892 |
|
160 |
157 |
$14K |
| 92083 |
|
395 |
358 |
$14K |
| 93890 |
|
159 |
156 |
$13K |
| 92273 |
|
198 |
190 |
$13K |
| 76514 |
|
1,803 |
1,630 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
206 |
187 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
658 |
433 |
$11K |
| 92133 |
|
453 |
417 |
$10K |
| 92260 |
|
774 |
704 |
$6K |
| 92065 |
|
248 |
102 |
$5K |
| 92275 |
|
94 |
88 |
$5K |
| 92341 |
|
167 |
164 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
118 |
69 |
$3K |
| 92283 |
|
64 |
60 |
$1K |
| 92060 |
|
14 |
12 |
$364.56 |
| 92285 |
|
12 |
12 |
$259.54 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$255.65 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
23 |
17 |
$188.30 |
| 0509T |
|
46 |
41 |
$77.28 |
| 92499 |
|
332 |
303 |
$20.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
14 |
12 |
$0.00 |
| G8732 |
No documentation of pain assessment, reason not given |
14 |
12 |
$0.00 |