| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,622 |
1,492 |
$150K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
562 |
562 |
$100K |
| 76511 |
|
1,824 |
986 |
$64K |
| 92020 |
|
2,079 |
1,981 |
$59K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
304 |
304 |
$41K |
| 92310 |
|
302 |
298 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
301 |
301 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
236 |
236 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
45 |
45 |
$5K |
| V2020 |
Frames, purchases |
262 |
262 |
$5K |
| 92015 |
Determination of refractive state |
2,077 |
2,053 |
$5K |
| 92002 |
|
119 |
119 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
33 |
33 |
$1K |
| 92083 |
|
12 |
12 |
$796.20 |
| 92201 |
|
24 |
24 |
$629.99 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
76 |
76 |
$456.00 |