| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,044 |
2,530 |
$168K |
| 68761 |
|
1,860 |
981 |
$154K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,501 |
2,298 |
$112K |
| 92250 |
|
2,681 |
2,441 |
$107K |
| 92285 |
|
4,001 |
3,325 |
$107K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,885 |
1,776 |
$79K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,183 |
1,832 |
$78K |
| 92015 |
Determination of refractive state |
3,422 |
3,270 |
$54K |
| 83861 |
|
2,641 |
1,527 |
$48K |
| 92083 |
|
1,092 |
931 |
$38K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
354 |
306 |
$24K |
| 83516 |
|
1,831 |
1,278 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
334 |
254 |
$21K |
| 92025 |
|
1,254 |
1,105 |
$18K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
367 |
296 |
$16K |
| 92060 |
|
586 |
506 |
$14K |
| 92133 |
|
471 |
406 |
$11K |
| 92134 |
|
449 |
418 |
$10K |
| 92100 |
|
330 |
293 |
$7K |
| V2025 |
Deluxe frame |
178 |
107 |
$2K |
| V2020 |
Frames, purchases |
29 |
29 |
$1K |
| 92201 |
|
56 |
44 |
$726.88 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
35 |
35 |
$450.10 |
| 76514 |
|
60 |
60 |
$372.84 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$352.98 |
| 92020 |
|
18 |
13 |
$331.50 |
| 92283 |
|
12 |
12 |
$188.88 |
| V2750 |
Anti-reflective coating, per lens |
21 |
12 |
$0.00 |