| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,366 |
6,071 |
$358K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,710 |
2,677 |
$226K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,036 |
2,146 |
$68K |
| 68761 |
|
976 |
460 |
$57K |
| V2020 |
Frames, purchases |
5,187 |
5,036 |
$56K |
| 92133 |
|
1,855 |
1,842 |
$50K |
| 92250 |
|
1,051 |
1,040 |
$43K |
| 92083 |
|
839 |
830 |
$37K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,336 |
718 |
$29K |
| 92202 |
|
1,242 |
1,228 |
$29K |
| 92020 |
|
1,567 |
1,532 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,458 |
793 |
$8K |
| 92225 |
|
299 |
159 |
$4K |
| 92226 |
|
262 |
140 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
195 |
109 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
110 |
105 |
$2K |
| 76514 |
|
180 |
177 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$892.61 |
| 92134 |
|
13 |
13 |
$253.86 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
461 |
233 |
$192.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$162.00 |
| 99072 |
|
14 |
14 |
$0.00 |