| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,319 |
1,280 |
$88K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,309 |
1,884 |
$84K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,503 |
1,452 |
$72K |
| 92015 |
Determination of refractive state |
2,760 |
2,683 |
$64K |
| V2020 |
Frames, purchases |
3,267 |
3,087 |
$64K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,447 |
2,329 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
898 |
862 |
$37K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,401 |
1,148 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
264 |
260 |
$14K |
| 92250 |
|
222 |
220 |
$7K |
| 92310 |
|
38 |
33 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
52 |
50 |
$6K |
| 92341 |
|
213 |
205 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
174 |
165 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
54 |
43 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
28 |
$2K |
| 68761 |
|
20 |
12 |
$2K |
| 92136 |
|
33 |
31 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
43 |
27 |
$1K |
| 92133 |
|
38 |
38 |
$774.60 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
12 |
12 |
$564.96 |
| 92083 |
|
12 |
12 |
$407.34 |