| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
3,410 |
3,396 |
$140K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,104 |
2,100 |
$107K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,263 |
1,261 |
$94K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,909 |
1,167 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
887 |
843 |
$27K |
| V2020 |
Frames, purchases |
1,631 |
1,612 |
$21K |
| 92083 |
|
404 |
395 |
$16K |
| 92285 |
|
419 |
417 |
$13K |
| 76512 |
|
154 |
90 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
68 |
67 |
$3K |
| 92060 |
|
69 |
69 |
$2K |
| 92020 |
|
156 |
154 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
32 |
17 |
$535.96 |
| 92133 |
|
13 |
13 |
$290.42 |
| 92202 |
|
18 |
18 |
$217.18 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
252 |
133 |
$139.00 |