| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,122 |
1,089 |
$230K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
780 |
772 |
$65K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
915 |
914 |
$64K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,309 |
1,298 |
$26K |
| 92015 |
Determination of refractive state |
2,677 |
2,660 |
$24K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
219 |
210 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
173 |
168 |
$8K |
| 92250 |
|
190 |
190 |
$3K |
| V2020 |
Frames, purchases |
103 |
101 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$382.38 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$348.32 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
12 |
$158.10 |
| 2022F |
|
15 |
15 |
$0.00 |