| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,507 |
4,117 |
$164K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,286 |
2,902 |
$145K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,703 |
1,561 |
$132K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,518 |
1,079 |
$69K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,370 |
1,236 |
$42K |
| V2760 |
Scratch resistant coating, per lens |
4,198 |
3,852 |
$40K |
| 92015 |
Determination of refractive state |
7,162 |
6,472 |
$33K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
757 |
659 |
$21K |
| 92134 |
|
3,173 |
2,385 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
808 |
571 |
$17K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,795 |
2,598 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
398 |
345 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
154 |
151 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
191 |
138 |
$7K |
| 92250 |
|
154 |
135 |
$2K |
| 92083 |
|
116 |
92 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
26 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
28 |
25 |
$936.62 |
| 92002 |
|
17 |
14 |
$628.37 |
| 92133 |
|
61 |
45 |
$237.04 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
133 |
121 |
$54.92 |