| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,945 |
4,929 |
$413K |
| 92250 |
|
8,859 |
8,813 |
$399K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,078 |
2,062 |
$149K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,488 |
2,473 |
$140K |
| 92285 |
|
4,587 |
4,522 |
$104K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,090 |
2,917 |
$99K |
| 68761 |
|
1,208 |
703 |
$91K |
| V2020 |
Frames, purchases |
4,555 |
4,501 |
$67K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,695 |
1,637 |
$66K |
| 92083 |
|
1,206 |
1,200 |
$56K |
| 92060 |
|
2,092 |
2,046 |
$56K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,657 |
966 |
$45K |
| 92202 |
|
1,296 |
1,277 |
$34K |
| 92133 |
|
927 |
925 |
$27K |
| 92020 |
|
923 |
920 |
$13K |
| 92132 |
|
161 |
161 |
$4K |
| 92015 |
Determination of refractive state |
4,228 |
4,193 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
74 |
74 |
$4K |
| 92134 |
|
79 |
78 |
$2K |
| 68840 |
|
44 |
44 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,515 |
778 |
$1K |
| 92225 |
|
61 |
32 |
$885.82 |
| 68801 |
|
28 |
28 |
$876.94 |
| 76514 |
|
32 |
32 |
$233.87 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
43 |
33 |
$154.00 |