| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,160 |
1,092 |
$174K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
757 |
703 |
$89K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
752 |
683 |
$68K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
448 |
426 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,078 |
740 |
$23K |
| V2020 |
Frames, purchases |
1,432 |
1,028 |
$22K |
| 92015 |
Determination of refractive state |
2,349 |
2,167 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
959 |
654 |
$9K |
| 92250 |
|
714 |
669 |
$7K |
| 92083 |
|
524 |
487 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$1K |
| 92341 |
|
14 |
12 |
$237.87 |