| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,928 |
1,745 |
$146K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,234 |
1,154 |
$86K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
509 |
493 |
$67K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,308 |
1,002 |
$37K |
| V2025 |
Deluxe frame |
378 |
339 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
494 |
415 |
$21K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
584 |
473 |
$19K |
| 92083 |
|
743 |
680 |
$18K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
279 |
241 |
$18K |
| 92250 |
|
1,101 |
993 |
$17K |
| 92341 |
|
456 |
402 |
$15K |
| V2760 |
Scratch resistant coating, per lens |
460 |
403 |
$10K |
| V2755 |
U-v lens, per lens |
455 |
400 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
51 |
51 |
$7K |
| 92133 |
|
437 |
404 |
$6K |
| 92020 |
|
304 |
281 |
$3K |
| 92134 |
|
182 |
161 |
$2K |
| V2020 |
Frames, purchases |
51 |
45 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$623.22 |
| 92015 |
Determination of refractive state |
232 |
162 |
$394.58 |