| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,658 |
1,470 |
$132K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,074 |
1,052 |
$118K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
524 |
513 |
$53K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
719 |
675 |
$51K |
| V2020 |
Frames, purchases |
657 |
652 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
426 |
355 |
$25K |
| 92015 |
Determination of refractive state |
3,438 |
3,326 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
173 |
152 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
40 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
68 |
68 |
$912.50 |
| 92250 |
|
26 |
25 |
$616.90 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
52 |
52 |
$475.00 |