| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
501 |
486 |
$18K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
144 |
142 |
$8K |
| 92060 |
|
123 |
123 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
39 |
39 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
34 |
34 |
$2K |
| V2020 |
Frames, purchases |
160 |
160 |
$647.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
62 |
62 |
$373.20 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
36 |
36 |
$352.62 |
| 92015 |
Determination of refractive state |
43 |
42 |
$178.11 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$32.00 |