| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,151 |
1,141 |
$97K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,960 |
765 |
$86K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,270 |
1,264 |
$75K |
| 92065 |
|
1,956 |
759 |
$52K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,500 |
742 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
401 |
382 |
$17K |
| 92250 |
|
401 |
400 |
$17K |
| V2020 |
Frames, purchases |
964 |
949 |
$11K |
| 92015 |
Determination of refractive state |
2,593 |
2,555 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,858 |
914 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$1K |
| 92083 |
|
27 |
27 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
13 |
$582.00 |