| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,537 |
1,367 |
$73K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,511 |
1,507 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,082 |
1,017 |
$12K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
240 |
200 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
77 |
76 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
27 |
$918.65 |
| V2025 |
Deluxe frame |
40 |
32 |
$372.71 |
| 92083 |
|
24 |
24 |
$269.92 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
28 |
27 |
$157.64 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
61 |
53 |
$77.19 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
61 |
53 |
$77.19 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
16 |
14 |
$68.70 |
| V2020 |
Frames, purchases |
42 |
36 |
$24.05 |