| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,731 |
5,627 |
$239K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
7,130 |
6,741 |
$150K |
| 92015 |
Determination of refractive state |
9,442 |
9,245 |
$137K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,360 |
1,305 |
$102K |
| V2020 |
Frames, purchases |
2,643 |
2,597 |
$56K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,236 |
1,301 |
$45K |
| 92134 |
|
2,964 |
2,907 |
$38K |
| 92133 |
|
1,333 |
1,311 |
$21K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
674 |
605 |
$20K |
| J9035 |
Injection, bevacizumab, 10 mg |
468 |
412 |
$16K |
| 92250 |
|
844 |
834 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
772 |
469 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
528 |
263 |
$5K |
| 76519 |
|
256 |
252 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
70 |
70 |
$2K |
| 92083 |
|
132 |
131 |
$2K |
| V2025 |
Deluxe frame |
59 |
58 |
$2K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
44 |
44 |
$1K |
| 68761 |
|
19 |
12 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
56 |
36 |
$632.86 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
15 |
12 |
$285.30 |
| 83861 |
|
714 |
357 |
$56.94 |
| 0517F |
|
585 |
575 |
$0.00 |
| 3285F |
|
585 |
575 |
$0.00 |
| 3284F |
|
691 |
683 |
$0.00 |