| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17,046 |
15,974 |
$894K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
16,412 |
15,079 |
$627K |
| V2020 |
Frames, purchases |
21,829 |
20,000 |
$457K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,375 |
8,651 |
$383K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,306 |
6,893 |
$361K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
4,740 |
4,068 |
$312K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,147 |
4,443 |
$304K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,150 |
1,885 |
$201K |
| 92015 |
Determination of refractive state |
13,392 |
11,903 |
$158K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,979 |
5,251 |
$156K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,258 |
2,067 |
$155K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
711 |
576 |
$137K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,158 |
3,303 |
$130K |
| 92134 |
|
5,529 |
4,654 |
$101K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,560 |
1,284 |
$95K |
| 92083 |
|
2,942 |
2,607 |
$84K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,253 |
1,861 |
$80K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
668 |
634 |
$77K |
| S0500 |
Disposable contact lens, per lens |
886 |
729 |
$74K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
552 |
526 |
$65K |
| 92133 |
|
2,833 |
2,443 |
$58K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
951 |
845 |
$49K |
| 92250 |
|
2,224 |
1,921 |
$48K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,448 |
943 |
$48K |
| V2599 |
Contact lens, other type |
197 |
197 |
$32K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
558 |
423 |
$25K |
| 92310 |
|
394 |
355 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
608 |
522 |
$17K |
| V2025 |
Deluxe frame |
659 |
659 |
$8K |
| 92136 |
|
385 |
305 |
$8K |
| 92020 |
|
626 |
539 |
$8K |
| 92002 |
|
151 |
143 |
$6K |
| 92326 |
|
93 |
92 |
$5K |
| 83861 |
|
453 |
204 |
$4K |
| 76514 |
|
473 |
422 |
$2K |
| 76519 |
|
60 |
51 |
$375.69 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
84 |
78 |
$0.00 |