| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,510 |
1,146 |
$331K |
| 92015 |
Determination of refractive state |
11,751 |
10,794 |
$205K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,871 |
6,180 |
$202K |
| V2020 |
Frames, purchases |
8,468 |
8,204 |
$154K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,864 |
3,390 |
$145K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,537 |
2,416 |
$102K |
| J0178 |
Injection, aflibercept, 1 mg |
106 |
91 |
$100K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,915 |
5,693 |
$99K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,955 |
1,819 |
$94K |
| 92134 |
|
3,589 |
3,155 |
$80K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,738 |
1,702 |
$79K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
596 |
400 |
$79K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
587 |
578 |
$36K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,217 |
1,193 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
378 |
370 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
783 |
637 |
$11K |
| J9035 |
Injection, bevacizumab, 10 mg |
158 |
121 |
$8K |
| 92136 |
|
643 |
300 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
181 |
154 |
$7K |
| 92202 |
|
840 |
780 |
$6K |
| 92250 |
|
236 |
220 |
$5K |
| 92341 |
|
209 |
202 |
$4K |
| 92225 |
|
299 |
152 |
$4K |
| 83861 |
|
192 |
129 |
$2K |
| 92226 |
|
309 |
165 |
$2K |
| 92025 |
|
201 |
177 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
35 |
29 |
$752.87 |
| 92002 |
|
22 |
16 |
$749.54 |
| 92235 |
|
18 |
16 |
$742.15 |
| 92201 |
|
48 |
43 |
$657.33 |
| 92133 |
|
58 |
50 |
$254.38 |