| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,362 |
2,116 |
$112K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
173 |
173 |
$19K |
| 92100 |
|
210 |
195 |
$12K |
| 92015 |
Determination of refractive state |
1,250 |
1,248 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
221 |
220 |
$11K |
| V2020 |
Frames, purchases |
437 |
436 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
160 |
160 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
45 |
45 |
$4K |
| 92250 |
|
156 |
73 |
$3K |
| 92341 |
|
57 |
56 |
$2K |
| 92020 |
|
55 |
54 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
41 |
41 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
27 |
$1K |
| 92083 |
|
26 |
25 |
$940.90 |
| 92225 |
|
21 |
20 |
$809.03 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$799.50 |
| 92133 |
|
25 |
24 |
$669.28 |
| 92201 |
|
12 |
12 |
$229.22 |