| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,775 |
2,772 |
$339K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,952 |
2,936 |
$257K |
| 92083 |
|
4,121 |
4,053 |
$199K |
| 92250 |
|
4,795 |
4,787 |
$156K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,721 |
1,719 |
$152K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,327 |
1,269 |
$82K |
| 92133 |
|
2,818 |
2,790 |
$78K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
310 |
296 |
$21K |
| V2020 |
Frames, purchases |
778 |
771 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
896 |
520 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
357 |
178 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
41 |
41 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
60 |
58 |
$3K |
| 92060 |
|
13 |
13 |
$560.77 |
| 92015 |
Determination of refractive state |
55 |
55 |
$120.33 |