| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,418 |
2,134 |
$177K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,165 |
1,090 |
$117K |
| 92250 |
|
1,365 |
1,284 |
$26K |
| 92015 |
Determination of refractive state |
1,241 |
1,185 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
347 |
347 |
$8K |
| V2020 |
Frames, purchases |
343 |
343 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
67 |
67 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
348 |
348 |
$2K |
| 92083 |
|
35 |
26 |
$1K |
| 92133 |
|
26 |
25 |
$570.91 |