| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,222 |
1,221 |
$71K |
| 92250 |
|
1,176 |
1,173 |
$50K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
526 |
524 |
$38K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,229 |
1,100 |
$37K |
| 92285 |
|
1,105 |
1,101 |
$28K |
| V2020 |
Frames, purchases |
1,863 |
1,838 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
568 |
567 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
609 |
578 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
196 |
194 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
188 |
180 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
74 |
37 |
$2K |
| 92083 |
|
39 |
38 |
$2K |
| 92133 |
|
24 |
24 |
$628.61 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
16 |
$622.40 |
| 92132 |
|
16 |
16 |
$384.90 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
52 |
26 |
$369.72 |
| 76514 |
|
40 |
40 |
$198.31 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,204 |
596 |
$180.00 |
| 92020 |
|
12 |
12 |
$165.11 |