| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,775 |
2,629 |
$156K |
| J0178 |
Injection, aflibercept, 1 mg |
76 |
55 |
$68K |
| 92250 |
|
1,590 |
1,505 |
$65K |
| 92015 |
Determination of refractive state |
4,903 |
4,406 |
$57K |
| 92134 |
|
2,285 |
1,908 |
$56K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
564 |
547 |
$51K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
386 |
270 |
$46K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
856 |
711 |
$31K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
250 |
246 |
$27K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
84 |
51 |
$26K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
189 |
182 |
$24K |
| 92225 |
|
1,120 |
542 |
$23K |
| 92285 |
|
839 |
576 |
$16K |
| V2020 |
Frames, purchases |
138 |
137 |
$11K |
| 92136 |
|
258 |
147 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
86 |
75 |
$7K |
| 92202 |
|
731 |
673 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
92 |
92 |
$6K |
| 92025 |
|
186 |
169 |
$4K |
| 99243 |
|
28 |
28 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
91 |
91 |
$3K |
| 99072 |
|
58 |
52 |
$979.56 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$761.52 |
| V2756 |
Eye glass case |
497 |
476 |
$728.84 |
| A4550 |
Surgical trays |
33 |
25 |
$474.40 |
| 92133 |
|
13 |
13 |
$345.40 |
| 76514 |
|
16 |
12 |
$112.17 |
| V2025 |
Deluxe frame |
138 |
138 |
$52.36 |
| 99024 |
|
14 |
13 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
64 |
64 |
$0.00 |