| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
670 |
636 |
$46K |
| 92015 |
Determination of refractive state |
1,564 |
1,423 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
679 |
641 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
700 |
623 |
$31K |
| V2020 |
Frames, purchases |
1,365 |
1,248 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,240 |
1,141 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
120 |
116 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
150 |
144 |
$11K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
609 |
552 |
$10K |
| 92370 |
|
1,350 |
1,159 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
209 |
191 |
$9K |
| 92250 |
|
183 |
173 |
$5K |
| 92083 |
|
134 |
128 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
86 |
78 |
$4K |
| 92133 |
|
152 |
145 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
47 |
45 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
15 |
$2K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
21 |
19 |
$2K |
| 92202 |
|
221 |
209 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
35 |
25 |
$2K |
| 92342 |
|
56 |
49 |
$1K |
| 92341 |
|
23 |
15 |
$436.04 |
| 99072 |
|
14 |
12 |
$0.00 |