| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,099 |
1,093 |
$82K |
| 92250 |
|
2,924 |
2,801 |
$75K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,237 |
1,355 |
$59K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
412 |
410 |
$52K |
| 92015 |
Determination of refractive state |
1,959 |
1,949 |
$43K |
| V2020 |
Frames, purchases |
2,417 |
2,401 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,013 |
2,005 |
$36K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
984 |
941 |
$28K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,479 |
1,295 |
$21K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
500 |
296 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
737 |
502 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
258 |
257 |
$16K |
| 92341 |
|
403 |
399 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
152 |
119 |
$8K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
148 |
97 |
$4K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
109 |
71 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
16 |
12 |
$606.30 |