| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,363 |
1,337 |
$103K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,200 |
1,124 |
$65K |
| 92250 |
|
899 |
890 |
$48K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,381 |
1,363 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
298 |
297 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
294 |
289 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
163 |
161 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
134 |
129 |
$5K |
| 92020 |
|
211 |
210 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$911.36 |
| 92310 |
|
24 |
24 |
$840.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
14 |
$560.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
15 |
$538.00 |
| 92015 |
Determination of refractive state |
156 |
139 |
$143.50 |