| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,914 |
4,593 |
$429K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,999 |
1,989 |
$352K |
| 76511 |
|
4,011 |
2,159 |
$228K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,462 |
1,450 |
$185K |
| 92020 |
|
4,801 |
4,090 |
$133K |
| 92015 |
Determination of refractive state |
9,439 |
7,743 |
$132K |
| 92310 |
|
1,114 |
968 |
$124K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
677 |
676 |
$73K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,730 |
1,716 |
$73K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,337 |
1,297 |
$58K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,825 |
1,520 |
$53K |
| V2020 |
Frames, purchases |
2,190 |
2,174 |
$45K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
787 |
772 |
$40K |
| 92285 |
|
853 |
815 |
$20K |
| 92201 |
|
590 |
459 |
$14K |
| 92002 |
|
287 |
279 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,777 |
957 |
$6K |
| 92226 |
|
191 |
176 |
$6K |
| 92083 |
|
67 |
67 |
$5K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
155 |
96 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
181 |
179 |
$5K |
| V2755 |
U-v lens, per lens |
393 |
200 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
26 |
$3K |
| 92225 |
|
73 |
60 |
$2K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
18 |
12 |
$2K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
23 |
12 |
$2K |
| 92342 |
|
12 |
12 |
$545.57 |
| 92133 |
|
14 |
14 |
$484.00 |
| V2750 |
Anti-reflective coating, per lens |
23 |
12 |
$442.05 |
| V2744 |
Tint, photochromatic, per lens |
23 |
12 |
$358.47 |
| V2299 |
Specialty bifocal (by report) |
18 |
12 |
$0.12 |