| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,325 |
1,284 |
$36K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,222 |
3,210 |
$25K |
| 92250 |
|
140 |
139 |
$5K |
| 92015 |
Determination of refractive state |
2,355 |
2,344 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
215 |
215 |
$2K |
| 92133 |
|
101 |
101 |
$2K |
| 92083 |
|
85 |
85 |
$1K |
| V2020 |
Frames, purchases |
1,774 |
1,756 |
$868.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,368 |
1,364 |
$591.66 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
64 |
45 |
$21.00 |
| V2750 |
Anti-reflective coating, per lens |
1,794 |
998 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
59 |
59 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
43 |
27 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
776 |
432 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
513 |
325 |
$0.00 |
| V2781 |
Progressive lens, per lens |
23 |
13 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
22 |
12 |
$0.00 |