| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,518 |
4,136 |
$408K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,968 |
2,767 |
$189K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
430 |
426 |
$55K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
562 |
557 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
505 |
477 |
$42K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
415 |
413 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
335 |
329 |
$25K |
| V2020 |
Frames, purchases |
872 |
855 |
$23K |
| 92015 |
Determination of refractive state |
1,036 |
1,027 |
$19K |
| 90832 |
Psychotherapy, 30 minutes with patient |
268 |
222 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
791 |
467 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
57 |
55 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
101 |
101 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
832 |
411 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
117 |
111 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
216 |
154 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
217 |
205 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
15 |
$575.58 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
16 |
14 |
$413.12 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
18 |
12 |
$340.20 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
23 |
16 |
$266.28 |
| 87807 |
|
12 |
12 |
$125.76 |
| 99173 |
|
14 |
14 |
$97.50 |
| 1160F |
|
123 |
107 |
$0.00 |
| 3078F |
|
45 |
42 |
$0.00 |
| 1159F |
|
123 |
107 |
$0.00 |
| 4274F |
|
14 |
14 |
$0.00 |
| 2010F |
|
212 |
184 |
$0.00 |
| 3351F |
|
32 |
29 |
$0.00 |
| 2000F |
|
192 |
165 |
$0.00 |
| 3008F |
|
204 |
181 |
$0.00 |
| 2001F |
|
205 |
180 |
$0.00 |
| 1036F |
|
63 |
53 |
$0.00 |
| 3074F |
|
119 |
110 |
$0.00 |