| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
920 |
830 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
886 |
843 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
609 |
602 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
700 |
700 |
$7K |
| 92134 |
|
312 |
305 |
$2K |
| 76512 |
|
45 |
32 |
$971.07 |
| 92015 |
Determination of refractive state |
854 |
852 |
$884.40 |
| 68761 |
|
43 |
39 |
$262.62 |
| V2020 |
Frames, purchases |
375 |
372 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
24 |
12 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
710 |
351 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
286 |
141 |
$0.00 |