| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,895 |
3,828 |
$200K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,617 |
1,616 |
$124K |
| 92226 |
|
4,270 |
2,141 |
$101K |
| 92225 |
|
3,316 |
1,664 |
$92K |
| 92015 |
Determination of refractive state |
3,847 |
3,844 |
$84K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,946 |
1,937 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
89 |
89 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
130 |
124 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
84 |
83 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
55 |
55 |
$1K |
| V2020 |
Frames, purchases |
42 |
42 |
$840.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
42 |
42 |
$798.00 |