| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,091 |
1,671 |
$92K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
949 |
804 |
$91K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,158 |
1,009 |
$88K |
| V2020 |
Frames, purchases |
1,773 |
1,508 |
$77K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
330 |
286 |
$33K |
| 92015 |
Determination of refractive state |
2,996 |
2,519 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
489 |
469 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
232 |
192 |
$11K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
458 |
166 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
63 |
56 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
229 |
206 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
37 |
30 |
$2K |
| 92083 |
|
33 |
26 |
$949.35 |
| 92133 |
|
50 |
39 |
$841.12 |
| 92250 |
|
14 |
12 |
$266.58 |
| 92134 |
|
12 |
12 |
$205.10 |
| 92020 |
|
16 |
12 |
$93.14 |
| V2750 |
Anti-reflective coating, per lens |
38 |
38 |
$23.44 |