| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,325 |
2,103 |
$159K |
| V2020 |
Frames, purchases |
2,768 |
2,406 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
365 |
338 |
$31K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
457 |
405 |
$31K |
| 92015 |
Determination of refractive state |
4,765 |
4,123 |
$30K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,301 |
2,081 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,308 |
1,141 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,215 |
1,047 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
295 |
249 |
$12K |
| 92250 |
|
305 |
236 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
125 |
92 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
69 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
13 |
12 |
$0.00 |
| 2022F |
|
14 |
13 |
$0.00 |