| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15,360 |
13,778 |
$732K |
| 92250 |
|
14,392 |
13,384 |
$485K |
| 92273 |
|
5,886 |
5,505 |
$435K |
| 92134 |
|
11,949 |
9,836 |
$264K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
6,070 |
5,288 |
$199K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,082 |
1,994 |
$141K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,432 |
1,015 |
$136K |
| 92235 |
|
2,054 |
1,897 |
$132K |
| V2020 |
Frames, purchases |
2,287 |
2,097 |
$132K |
| 92083 |
|
3,277 |
3,129 |
$107K |
| 92133 |
|
4,161 |
3,934 |
$104K |
| 92226 |
|
6,137 |
2,928 |
$94K |
| 92060 |
|
2,170 |
2,076 |
$91K |
| 92015 |
Determination of refractive state |
8,829 |
7,149 |
$72K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,475 |
1,140 |
$60K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
878 |
591 |
$49K |
| 76512 |
|
1,021 |
482 |
$49K |
| 92275 |
|
665 |
657 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
482 |
446 |
$46K |
| 92225 |
|
2,209 |
1,074 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,447 |
1,369 |
$37K |
| J7999 |
Compounded drug, not otherwise classified |
592 |
400 |
$35K |
| 92285 |
|
2,445 |
1,825 |
$30K |
| 92202 |
|
3,258 |
2,875 |
$26K |
| 99072 |
|
1,670 |
1,370 |
$25K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
665 |
610 |
$23K |
| V2025 |
Deluxe frame |
1,414 |
1,377 |
$21K |
| 92341 |
|
540 |
496 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
200 |
181 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
756 |
741 |
$7K |
| A4550 |
Surgical trays |
396 |
301 |
$6K |
| V2756 |
Eye glass case |
3,497 |
3,301 |
$6K |
| 92286 |
|
73 |
69 |
$4K |
| 92025 |
|
151 |
142 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
29 |
25 |
$2K |
| 76514 |
|
292 |
285 |
$2K |
| 92136 |
|
33 |
13 |
$1K |
| 92020 |
|
41 |
40 |
$544.85 |
| V2744 |
Tint, photochromatic, per lens |
29 |
24 |
$113.68 |
| 92132 |
|
30 |
28 |
$90.84 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$66.44 |
| S9999 |
Sales tax |
16 |
16 |
$0.00 |