| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,392 |
2,064 |
$99K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,134 |
1,055 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
834 |
752 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,553 |
1,170 |
$34K |
| V2020 |
Frames, purchases |
2,472 |
2,196 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
784 |
615 |
$22K |
| 92015 |
Determination of refractive state |
3,086 |
2,665 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,684 |
1,619 |
$18K |
| 93886 |
|
70 |
59 |
$10K |
| 93892 |
|
70 |
59 |
$9K |
| 92134 |
|
448 |
380 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
189 |
184 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
823 |
564 |
$5K |
| 93890 |
|
74 |
59 |
$3K |
| V2799 |
Vision item or service, miscellaneous |
298 |
294 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
35 |
31 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$1K |
| 92250 |
|
27 |
25 |
$569.61 |
| 92133 |
|
12 |
12 |
$299.04 |
| 83861 |
|
34 |
15 |
$170.40 |
| 83516 |
|
24 |
12 |
$96.46 |
| 76514 |
|
13 |
12 |
$81.21 |
| 99024 |
|
14 |
13 |
$0.00 |