| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
766 |
764 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
660 |
659 |
$28K |
| 92015 |
Determination of refractive state |
1,636 |
1,615 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
602 |
595 |
$17K |
| V2020 |
Frames, purchases |
672 |
666 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
476 |
473 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
314 |
313 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
43 |
43 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
114 |
114 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
19 |
19 |
$882.55 |
| M1208 |
Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
29 |
29 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
15 |
15 |
$0.00 |