| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,171 |
1,071 |
$77K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,381 |
1,175 |
$65K |
| 92015 |
Determination of refractive state |
2,304 |
2,160 |
$53K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
711 |
664 |
$33K |
| V2020 |
Frames, purchases |
1,876 |
1,794 |
$30K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,298 |
1,205 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,369 |
1,270 |
$23K |
| 92370 |
|
2,205 |
2,049 |
$18K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
233 |
215 |
$18K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
197 |
187 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
427 |
420 |
$16K |
| 68761 |
|
69 |
54 |
$13K |
| 92250 |
|
312 |
254 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
230 |
221 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
172 |
161 |
$9K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
116 |
109 |
$8K |
| 92342 |
|
321 |
301 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
217 |
206 |
$6K |
| 92083 |
|
191 |
158 |
$6K |
| 92341 |
|
265 |
250 |
$5K |
| 92133 |
|
194 |
156 |
$5K |
| 92225 |
|
99 |
86 |
$3K |
| 92226 |
|
131 |
106 |
$2K |
| 92134 |
|
90 |
80 |
$2K |
| 92025 |
|
59 |
57 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
16 |
$804.96 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22 |
17 |
$780.86 |
| 76514 |
|
44 |
38 |
$307.04 |
| V2756 |
Eye glass case |
17 |
17 |
$90.00 |