| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
626 |
539 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
779 |
602 |
$30K |
| 92015 |
Determination of refractive state |
2,603 |
2,269 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
258 |
238 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
34 |
31 |
$3K |
| V2020 |
Frames, purchases |
242 |
209 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
102 |
97 |
$2K |
| 92136 |
|
85 |
64 |
$1K |
| 92134 |
|
22 |
15 |
$303.54 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
24 |
$0.00 |