| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,205 |
1,154 |
$45K |
| V2020 |
Frames, purchases |
1,271 |
1,099 |
$34K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,188 |
1,162 |
$29K |
| 92134 |
|
1,622 |
1,586 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
109 |
108 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
348 |
342 |
$3K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
64 |
55 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
92 |
37 |
$2K |
| 92002 |
|
55 |
52 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
726 |
296 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
26 |
$946.88 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
23 |
12 |
$588.28 |
| 92015 |
Determination of refractive state |
394 |
379 |
$431.90 |
| 76519 |
|
13 |
12 |
$276.19 |