| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
11,027 |
9,926 |
$874K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13,543 |
11,799 |
$862K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,315 |
7,309 |
$786K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
4,639 |
4,214 |
$440K |
| 92060 |
|
10,750 |
9,415 |
$412K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
23,659 |
20,714 |
$404K |
| 92015 |
Determination of refractive state |
9,307 |
7,457 |
$177K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,722 |
3,038 |
$175K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,282 |
2,740 |
$168K |
| 92370 |
|
23,581 |
21,131 |
$149K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,841 |
2,429 |
$147K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,714 |
1,144 |
$101K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
612 |
560 |
$68K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,134 |
514 |
$59K |
| 92134 |
|
4,088 |
3,311 |
$49K |
| 99254 |
|
400 |
315 |
$47K |
| 99223 |
Prolong inpt eval add15 m |
74 |
71 |
$11K |
| 92201 |
|
2,673 |
1,196 |
$3K |
| 92083 |
|
131 |
107 |
$3K |
| J9035 |
Injection, bevacizumab, 10 mg |
46 |
37 |
$2K |
| 99233 |
Prolong inpt eval add15 m |
24 |
12 |
$2K |
| 92133 |
|
72 |
64 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$1K |
| 92226 |
|
511 |
266 |
$188.28 |
| 92225 |
|
93 |
88 |
$88.83 |
| V2020 |
Frames, purchases |
285 |
163 |
$19.49 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
456 |
122 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
214 |
69 |
$0.00 |