| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,822 |
3,544 |
$307K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
971 |
900 |
$118K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
963 |
963 |
$117K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
932 |
930 |
$89K |
| 92225 |
|
1,363 |
807 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
254 |
251 |
$16K |
| 92202 |
|
1,507 |
1,506 |
$14K |
| 92226 |
|
636 |
339 |
$13K |
| V2020 |
Frames, purchases |
875 |
746 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
565 |
477 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
211 |
210 |
$5K |
| 92015 |
Determination of refractive state |
1,403 |
1,370 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
572 |
546 |
$4K |
| 92060 |
|
79 |
79 |
$4K |
| 92201 |
|
119 |
118 |
$2K |