| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
304 |
281 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
695 |
685 |
$19K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
152 |
147 |
$19K |
| 92060 |
|
198 |
187 |
$12K |
| 92226 |
|
318 |
163 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
152 |
149 |
$9K |
| V2020 |
Frames, purchases |
395 |
386 |
$8K |
| V2025 |
Deluxe frame |
124 |
124 |
$6K |
| 99233 |
Prolong inpt eval add15 m |
66 |
29 |
$5K |
| 92015 |
Determination of refractive state |
600 |
589 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
101 |
101 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
724 |
713 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
41 |
41 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$2K |
| 92225 |
|
33 |
26 |
$920.78 |