| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,441 |
3,247 |
$180K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,010 |
1,823 |
$158K |
| V2750 |
Anti-reflective coating, per lens |
1,625 |
1,562 |
$104K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,895 |
5,598 |
$96K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,017 |
5,688 |
$69K |
| V2020 |
Frames, purchases |
6,031 |
5,750 |
$60K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,758 |
2,326 |
$58K |
| 92015 |
Determination of refractive state |
6,624 |
6,221 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,215 |
3,061 |
$45K |
| 92134 |
|
2,341 |
2,038 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,204 |
1,147 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
198 |
182 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
390 |
370 |
$15K |
| 92285 |
|
881 |
735 |
$12K |
| 92250 |
|
295 |
261 |
$7K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
58 |
53 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
246 |
235 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
106 |
96 |
$3K |
| 92025 |
|
388 |
329 |
$2K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
16 |
13 |
$2K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
65 |
50 |
$2K |
| 92002 |
|
44 |
43 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
13 |
$1K |
| 92136 |
|
48 |
28 |
$878.21 |
| 92060 |
|
34 |
26 |
$851.00 |
| 92083 |
|
29 |
27 |
$506.26 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
12 |
12 |
$311.00 |
| 92133 |
|
26 |
25 |
$216.43 |
| S9999 |
Sales tax |
12 |
12 |
$0.00 |