| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
668 |
668 |
$58K |
| 92250 |
|
805 |
805 |
$35K |
| 99215 |
Prolong outpt/office vis |
424 |
423 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,588 |
784 |
$33K |
| V2020 |
Frames, purchases |
1,519 |
1,495 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
233 |
232 |
$17K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
284 |
140 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
116 |
116 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
38 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,014 |
1,485 |
$1K |
| 92134 |
|
12 |
12 |
$360.24 |