| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,651 |
5,111 |
$201K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,828 |
2,824 |
$187K |
| 68761 |
|
1,400 |
695 |
$126K |
| V2020 |
Frames, purchases |
4,099 |
4,051 |
$84K |
| 92133 |
|
2,307 |
2,300 |
$79K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,518 |
3,474 |
$74K |
| 92250 |
|
1,248 |
1,242 |
$49K |
| 92083 |
|
1,859 |
1,773 |
$44K |
| 92015 |
Determination of refractive state |
5,220 |
5,197 |
$41K |
| 92020 |
|
2,488 |
2,477 |
$40K |
| 76514 |
|
2,562 |
2,548 |
$24K |
| 92132 |
|
817 |
817 |
$23K |
| 92341 |
|
432 |
430 |
$13K |
| 92100 |
|
399 |
367 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
254 |
253 |
$10K |
| 92025 |
|
375 |
375 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
86 |
86 |
$5K |
| 92134 |
|
95 |
94 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
65 |
65 |
$960.03 |
| 99215 |
Prolong outpt/office vis |
17 |
17 |
$890.71 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
46 |
45 |
$364.32 |