| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,165 |
7,543 |
$220K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,476 |
7,332 |
$154K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,857 |
4,771 |
$97K |
| 92250 |
|
2,699 |
2,576 |
$77K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,605 |
3,476 |
$58K |
| 92133 |
|
1,607 |
1,535 |
$27K |
| 92083 |
|
1,874 |
1,802 |
$25K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,206 |
3,993 |
$23K |
| 92015 |
Determination of refractive state |
8,800 |
8,626 |
$21K |
| 92341 |
|
1,057 |
1,045 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
501 |
480 |
$17K |
| 65855 |
|
22 |
14 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
190 |
144 |
$3K |
| V2020 |
Frames, purchases |
6,533 |
6,449 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,108 |
4,082 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,112 |
577 |
$728.00 |
| 76514 |
|
54 |
54 |
$523.71 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,138 |
568 |
$17.00 |
| 3072F |
|
2,567 |
2,543 |
$0.00 |
| V2781 |
Progressive lens, per lens |
78 |
40 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
112 |
56 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
56 |
28 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
146 |
73 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
107 |
54 |
$0.00 |
| 2022F |
|
13 |
13 |
$0.00 |