| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,205 |
4,807 |
$288K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,058 |
1,902 |
$168K |
| V2020 |
Frames, purchases |
4,681 |
4,271 |
$108K |
| 92015 |
Determination of refractive state |
7,542 |
6,929 |
$98K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,181 |
1,991 |
$42K |
| 92370 |
|
343 |
316 |
$5K |
| V2756 |
Eye glass case |
4,405 |
4,025 |
$4K |
| 92250 |
|
111 |
91 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
50 |
39 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
51 |
51 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
55 |
40 |
$836.14 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$668.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
20 |
12 |
$165.68 |
| 1036F |
|
15 |
13 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
27 |
25 |
$0.00 |