| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
53,331 |
47,437 |
$9.27M |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,329 |
2,081 |
$128K |
| V2020 |
Frames, purchases |
2,171 |
2,088 |
$85K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
2,085 |
1,001 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,176 |
12,302 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,048 |
553 |
$32K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,165 |
3,115 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,774 |
10,954 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,501 |
2,387 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,550 |
2,526 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,417 |
1,395 |
$7K |
| 90686 |
|
1,431 |
1,423 |
$5K |
| 99205 |
Prolong outpt/office vis |
36 |
36 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,702 |
1,616 |
$3K |
| 92015 |
Determination of refractive state |
2,644 |
2,434 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
645 |
593 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,166 |
1,135 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
662 |
545 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
155 |
153 |
$2K |
| 99215 |
Prolong outpt/office vis |
1,101 |
1,049 |
$2K |
| 90670 |
|
1,444 |
1,429 |
$2K |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
60 |
30 |
$2K |
| 90723 |
|
1,322 |
1,311 |
$1K |
| 90647 |
|
1,147 |
1,136 |
$1K |
| 90680 |
|
1,045 |
1,036 |
$1K |
| 90633 |
|
788 |
773 |
$890.70 |
| 90715 |
|
141 |
139 |
$821.66 |
| G0008 |
Administration of influenza virus vaccine |
455 |
431 |
$694.70 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
20 |
12 |
$576.00 |
| 90710 |
|
441 |
438 |
$573.70 |
| 90651 |
|
523 |
521 |
$565.80 |
| 0011A |
|
12 |
12 |
$480.00 |
| 92551 |
|
4,231 |
4,137 |
$391.64 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
2,662 |
2,491 |
$275.77 |
| 3078F |
|
80 |
74 |
$260.00 |
| 99499 |
|
13 |
13 |
$235.00 |
| 3074F |
|
87 |
82 |
$220.00 |
| 90734 |
|
394 |
391 |
$177.20 |
| 99173 |
|
3,815 |
3,732 |
$106.95 |
| 0124A |
|
12 |
12 |
$80.00 |
| 99177 |
|
69 |
69 |
$69.00 |
| 83655 |
|
1,939 |
1,894 |
$64.50 |
| 3079F |
|
42 |
42 |
$60.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
141 |
136 |
$54.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
358 |
349 |
$48.24 |
| 81025 |
|
24 |
24 |
$47.60 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
562 |
544 |
$41.00 |
| 0012A |
|
14 |
14 |
$40.00 |
| 85018 |
|
512 |
506 |
$3.71 |
| 80061 |
Lipid panel |
793 |
779 |
$0.00 |
| 90700 |
|
151 |
150 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
115 |
93 |
$0.00 |
| 90750 |
|
39 |
39 |
$0.00 |
| 90648 |
|
86 |
86 |
$0.00 |
| 90707 |
|
27 |
27 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
43 |
43 |
$0.00 |
| 90461 |
|
13 |
13 |
$0.00 |
| 90681 |
|
38 |
38 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
16 |
15 |
$0.00 |
| 90677 |
|
311 |
308 |
$0.00 |
| 96127 |
|
823 |
810 |
$0.00 |
| 3008F |
|
1,186 |
1,113 |
$0.00 |
| 90656 |
|
278 |
276 |
$0.00 |
| 91301 |
|
16 |
16 |
$0.00 |
| 99383 |
|
54 |
54 |
$0.00 |
| 90696 |
|
114 |
114 |
$0.00 |
| 90716 |
|
40 |
40 |
$0.00 |
| 99381 |
|
38 |
38 |
$0.00 |
| G0010 |
Administration of hepatitis b vaccine |
30 |
30 |
$0.00 |
| 99385 |
|
42 |
40 |
$0.00 |
| 99459 |
|
28 |
28 |
$0.00 |
| 91307 |
|
39 |
38 |
$0.00 |