| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
10,751 |
10,583 |
$327K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
6,894 |
6,664 |
$306K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
6,136 |
5,993 |
$279K |
| V2020 |
Frames, purchases |
11,830 |
11,662 |
$189K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
988 |
949 |
$71K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
449 |
440 |
$45K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,465 |
3,443 |
$43K |
| 92134 |
|
931 |
859 |
$19K |
| 92015 |
Determination of refractive state |
1,471 |
1,433 |
$14K |
| 00142 |
|
68 |
52 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
102 |
91 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
72 |
63 |
$3K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
64 |
58 |
$3K |
| J9035 |
Injection, bevacizumab, 10 mg |
58 |
52 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
25 |
25 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
73 |
44 |
$977.95 |