| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,655 |
1,403 |
$84K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
813 |
712 |
$55K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
510 |
446 |
$19K |
| 92250 |
|
756 |
683 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
280 |
260 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
225 |
213 |
$6K |
| V2020 |
Frames, purchases |
135 |
135 |
$3K |
| 92134 |
|
60 |
49 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
138 |
138 |
$856.36 |
| 92133 |
|
25 |
25 |
$451.61 |
| 92015 |
Determination of refractive state |
847 |
741 |
$190.56 |