| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,947 |
5,901 |
$171K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,513 |
2,504 |
$114K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,831 |
1,820 |
$87K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,462 |
4,433 |
$83K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,277 |
1,233 |
$57K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
720 |
711 |
$40K |
| 92341 |
|
1,478 |
1,469 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
472 |
471 |
$29K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,953 |
1,517 |
$21K |
| 92015 |
Determination of refractive state |
2,449 |
2,421 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,069 |
979 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
354 |
351 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
769 |
761 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
126 |
124 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
202 |
194 |
$5K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
78 |
78 |
$5K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
68 |
67 |
$4K |
| 92065 |
|
84 |
40 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
158 |
131 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
51 |
50 |
$1K |
| 92060 |
|
13 |
13 |
$444.43 |