| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
4,627 |
4,612 |
$207K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,420 |
2,300 |
$87K |
| 68761 |
|
1,017 |
625 |
$77K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,207 |
1,177 |
$69K |
| 92285 |
|
2,573 |
2,516 |
$61K |
| 92083 |
|
1,077 |
1,063 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,763 |
1,588 |
$47K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
806 |
803 |
$47K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
625 |
619 |
$41K |
| V2020 |
Frames, purchases |
3,245 |
3,235 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
288 |
281 |
$18K |
| 92133 |
|
578 |
573 |
$16K |
| 92202 |
|
196 |
128 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
392 |
240 |
$2K |
| 76514 |
|
198 |
197 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
97 |
97 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
28 |
27 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
452 |
245 |
$978.32 |
| 92134 |
|
16 |
16 |
$443.96 |
| 92225 |
|
16 |
14 |
$397.32 |
| 92201 |
|
16 |
15 |
$259.91 |
| 92015 |
Determination of refractive state |
12 |
12 |
$144.00 |
| 92025 |
|
17 |
17 |
$60.12 |