| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,978 |
3,435 |
$143K |
| V2020 |
Frames, purchases |
11,324 |
11,075 |
$127K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,661 |
2,639 |
$89K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,200 |
2,200 |
$89K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,013 |
2,040 |
$78K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,173 |
586 |
$34K |
| 92273 |
|
825 |
805 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
848 |
806 |
$21K |
| 95930 |
|
346 |
342 |
$10K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
225 |
225 |
$9K |
| 92083 |
|
328 |
326 |
$9K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
407 |
202 |
$8K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
46 |
39 |
$8K |
| 92134 |
|
842 |
815 |
$7K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
167 |
167 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
457 |
437 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
22,384 |
11,003 |
$6K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
282 |
245 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
170 |
83 |
$3K |
| 92133 |
|
202 |
200 |
$3K |
| J9035 |
Injection, bevacizumab, 10 mg |
106 |
97 |
$1K |
| 76519 |
|
126 |
94 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
44 |
24 |
$1K |
| 92250 |
|
62 |
60 |
$625.63 |
| 92136 |
|
86 |
53 |
$386.55 |
| 92020 |
|
25 |
24 |
$136.10 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
24 |
24 |
$116.12 |
| 4040F |
|
2,269 |
2,204 |
$0.05 |
| G8482 |
Influenza immunization administered or previously received |
530 |
516 |
$0.04 |
| 1036F |
|
2,194 |
2,119 |
$0.02 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
160 |
158 |
$0.02 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
1,514 |
1,491 |
$0.01 |
| 2022F |
|
404 |
367 |
$0.01 |
| 3285F |
|
302 |
283 |
$0.00 |
| 3284F |
|
307 |
288 |
$0.00 |
| 4177F |
|
26 |
25 |
$0.00 |
| 3072F |
|
28 |
25 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
13 |
13 |
$0.00 |
| 2024F |
|
387 |
351 |
$0.00 |
| 4004F |
|
215 |
207 |
$0.00 |
| 2026F |
|
380 |
345 |
$0.00 |
| 2027F |
|
68 |
64 |
$0.00 |
| 0517F |
|
99 |
95 |
$0.00 |
| 92015 |
Determination of refractive state |
2,141 |
2,135 |
$0.00 |
| G9974 |
Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity |
12 |
12 |
$0.00 |