| Code | Description | Claims | Beneficiaries | Total Paid |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,168 |
4,482 |
$236K |
| V2020 |
Frames, purchases |
5,356 |
5,099 |
$175K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,385 |
2,736 |
$148K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,215 |
2,033 |
$120K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,056 |
2,025 |
$107K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,857 |
2,400 |
$81K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,232 |
1,143 |
$76K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,067 |
932 |
$69K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,709 |
1,591 |
$52K |
| 92250 |
|
2,648 |
2,217 |
$51K |
| 92134 |
|
2,410 |
2,000 |
$42K |
| 92083 |
|
1,353 |
1,057 |
$35K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
870 |
803 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,057 |
855 |
$30K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
532 |
486 |
$21K |
| 92133 |
|
988 |
753 |
$17K |
| 92015 |
Determination of refractive state |
3,298 |
2,802 |
$13K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
169 |
166 |
$11K |
| V2025 |
Deluxe frame |
229 |
229 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
67 |
55 |
$3K |
| 92201 |
|
161 |
139 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
12 |
$1K |
| 83861 |
|
129 |
54 |
$389.14 |
| 92226 |
|
76 |
39 |
$312.88 |
| 67028 |
Intravitreal injection of a pharmacologic agent |
19 |
12 |
$38.84 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
14 |
$0.00 |