| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
11,793 |
11,386 |
$368K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,802 |
5,100 |
$182K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,339 |
2,235 |
$147K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,400 |
3,330 |
$117K |
| 92250 |
|
2,794 |
2,616 |
$71K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,095 |
1,713 |
$68K |
| 92134 |
|
3,840 |
3,520 |
$55K |
| 92083 |
|
2,433 |
2,325 |
$48K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
880 |
716 |
$45K |
| 92133 |
|
2,543 |
2,425 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,491 |
1,473 |
$23K |
| 92015 |
Determination of refractive state |
4,898 |
4,712 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
441 |
392 |
$15K |
| J9035 |
Injection, bevacizumab, 10 mg |
200 |
162 |
$14K |
| 65855 |
|
94 |
57 |
$12K |
| 92225 |
|
380 |
260 |
$8K |
| 92136 |
|
197 |
180 |
$4K |
| 92226 |
|
155 |
105 |
$3K |
| 76514 |
|
275 |
266 |
$2K |
| 68761 |
|
13 |
12 |
$977.92 |
| 99443 |
|
56 |
54 |
$742.27 |
| 92025 |
|
57 |
53 |
$704.88 |
| 92202 |
|
135 |
119 |
$439.72 |
| V2020 |
Frames, purchases |
1,653 |
1,636 |
$220.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,947 |
1,017 |
$197.60 |
| 92020 |
|
18 |
18 |
$195.80 |
| 92286 |
|
13 |
12 |
$160.19 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
804 |
414 |
$42.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
610 |
308 |
$42.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
48 |
48 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
74 |
37 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
95 |
95 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
41 |
21 |
$0.00 |
| 99072 |
|
25 |
22 |
$0.00 |