| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,352 |
2,332 |
$217K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,441 |
1,434 |
$99K |
| V2020 |
Frames, purchases |
3,300 |
3,021 |
$84K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,198 |
2,182 |
$64K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,425 |
2,244 |
$41K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,574 |
2,364 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
226 |
191 |
$9K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
225 |
205 |
$6K |
| 92015 |
Determination of refractive state |
3,813 |
3,778 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
256 |
238 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
1,711 |
1,700 |
$4K |
| 92370 |
|
121 |
121 |
$3K |
| 92341 |
|
64 |
60 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
106 |
96 |
$1K |
| S0516 |
Safety eyeglass frames |
25 |
25 |
$399.50 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
40 |
40 |
$369.82 |
| S9999 |
Sales tax |
71 |
71 |
$125.70 |
| G9905 |
Patient not screened for tobacco use |
663 |
653 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
594 |
567 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
3,527 |
3,378 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
346 |
337 |
$0.00 |
| G2104 |
Eye imaging validated to match diagnosis from seven standard field stereoscopic photos results documented and reviewed |
15 |
15 |
$0.00 |
| 4004F |
|
378 |
354 |
$0.00 |
| 2026F |
|
243 |
239 |
$0.00 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
59 |
56 |
$0.00 |
| 2022F |
|
12 |
12 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
732 |
699 |
$0.00 |
| G9906 |
Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) |
731 |
698 |
$0.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
771 |
736 |
$0.00 |
| 1036F |
|
2,870 |
2,753 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
2,835 |
2,718 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
12 |
12 |
$0.00 |