| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,537 |
5,193 |
$268K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,524 |
4,134 |
$188K |
| 92015 |
Determination of refractive state |
8,143 |
7,820 |
$156K |
| V2020 |
Frames, purchases |
7,685 |
7,454 |
$139K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,601 |
6,360 |
$116K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,692 |
1,564 |
$58K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
700 |
687 |
$50K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
5,928 |
2,854 |
$50K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
565 |
553 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
457 |
450 |
$28K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
40 |
40 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
184 |
119 |
$5K |
| 68761 |
|
32 |
25 |
$4K |
| 92250 |
|
151 |
150 |
$4K |
| 92310 |
|
15 |
15 |
$2K |
| 92133 |
|
63 |
62 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
198 |
151 |
$574.35 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
20 |
19 |
$320.00 |
| 92341 |
|
12 |
12 |
$240.00 |