| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,751 |
3,576 |
$190K |
| 92015 |
Determination of refractive state |
13,434 |
12,721 |
$175K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,983 |
3,874 |
$154K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,866 |
1,719 |
$126K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,416 |
1,367 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,236 |
1,220 |
$47K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,029 |
2,004 |
$43K |
| 92341 |
|
985 |
971 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
359 |
332 |
$18K |
| 99205 |
Prolong outpt/office vis |
103 |
96 |
$9K |
| 92250 |
|
107 |
100 |
$3K |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$806.67 |
| 92060 |
|
24 |
24 |
$471.52 |
| 2023F |
|
1,235 |
1,117 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,349 |
1,333 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,823 |
2,789 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$0.00 |
| 3072F |
|
122 |
122 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$0.00 |
| V2781 |
Progressive lens, per lens |
27 |
27 |
$0.00 |
| V2020 |
Frames, purchases |
3,085 |
3,044 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
740 |
731 |
$0.00 |