| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,023 |
1,013 |
$56K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,189 |
3,176 |
$38K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,567 |
2,542 |
$13K |
| V2020 |
Frames, purchases |
10,253 |
10,191 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,718 |
5,637 |
$7K |
| 92250 |
|
565 |
556 |
$6K |
| 92015 |
Determination of refractive state |
2,596 |
2,587 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
3,162 |
2,563 |
$4K |
| 76512 |
|
181 |
118 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
499 |
496 |
$93.00 |
| 68761 |
|
19 |
12 |
$45.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,227 |
671 |
$10.50 |
| 3072F |
|
800 |
795 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
283 |
267 |
$0.00 |
| V2781 |
Progressive lens, per lens |
271 |
260 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
45 |
45 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
184 |
114 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
867 |
483 |
$0.00 |