| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
2,345 |
2,339 |
$137K |
| 92015 |
Determination of refractive state |
7,946 |
7,898 |
$121K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,069 |
2,365 |
$88K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,407 |
1,403 |
$83K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
6,910 |
6,829 |
$83K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,496 |
3,445 |
$71K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,103 |
2,022 |
$47K |
| 92250 |
|
4,132 |
3,906 |
$40K |
| 92020 |
|
3,969 |
3,911 |
$14K |
| 68801 |
|
682 |
678 |
$8K |
| 92273 |
|
857 |
851 |
$6K |
| 95930 |
|
351 |
332 |
$5K |
| 92275 |
|
147 |
138 |
$3K |
| V2020 |
Frames, purchases |
48 |
48 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
127 |
127 |
$929.96 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
811 |
803 |
$801.17 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
331 |
331 |
$734.43 |
| 92283 |
|
277 |
273 |
$171.75 |
| 92134 |
|
13 |
12 |
$63.24 |
| 92133 |
|
13 |
13 |
$62.26 |
| 65222 |
|
13 |
13 |
$52.39 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
846 |
846 |
$32.02 |