| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,101 |
975 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
118 |
114 |
$10K |
| V2020 |
Frames, purchases |
391 |
343 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
88 |
66 |
$5K |
| 92015 |
Determination of refractive state |
280 |
254 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
133 |
67 |
$3K |
| 92250 |
|
84 |
75 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
22 |
13 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18 |
12 |
$512.82 |