| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
279 |
241 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
498 |
460 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
267 |
227 |
$14K |
| 92015 |
Determination of refractive state |
1,501 |
1,335 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
147 |
143 |
$6K |
| V2020 |
Frames, purchases |
245 |
190 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
192 |
93 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
105 |
76 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
21 |
16 |
$700.94 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$674.67 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
42 |
29 |
$247.50 |