| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 68761 |
|
1,091 |
545 |
$85K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,491 |
1,475 |
$71K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
871 |
860 |
$69K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,368 |
1,240 |
$46K |
| V2020 |
Frames, purchases |
1,640 |
1,603 |
$17K |
| 92285 |
|
333 |
330 |
$9K |
| 92250 |
|
162 |
162 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
146 |
143 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
411 |
404 |
$3K |
| 92015 |
Determination of refractive state |
1,204 |
1,193 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,338 |
1,148 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
58 |
56 |
$576.50 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
12 |
12 |
$108.00 |