| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
33,376 |
17,987 |
$1.08M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15,120 |
14,766 |
$633K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
13,041 |
5,711 |
$580K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
20,964 |
12,332 |
$399K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
10,697 |
10,402 |
$309K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,001 |
3,930 |
$232K |
| 92015 |
Determination of refractive state |
32,676 |
31,931 |
$186K |
| V2020 |
Frames, purchases |
26,519 |
25,056 |
$184K |
| J0178 |
Injection, aflibercept, 1 mg |
1,560 |
1,365 |
$179K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,571 |
2,280 |
$145K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,491 |
3,416 |
$87K |
| 92134 |
|
4,263 |
3,935 |
$80K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,217 |
1,078 |
$49K |
| V2025 |
Deluxe frame |
252 |
218 |
$23K |
| 92002 |
|
773 |
763 |
$21K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
69 |
65 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
681 |
654 |
$14K |
| 92083 |
|
279 |
240 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
102 |
98 |
$8K |
| 92250 |
|
200 |
189 |
$8K |
| 92133 |
|
307 |
276 |
$8K |
| V2750 |
Anti-reflective coating, per lens |
115 |
91 |
$7K |
| 92285 |
|
463 |
445 |
$5K |
| 92020 |
|
560 |
550 |
$5K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
131 |
130 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
96 |
91 |
$4K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
84 |
41 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
102 |
98 |
$2K |
| J9035 |
Injection, bevacizumab, 10 mg |
651 |
536 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
59 |
39 |
$1K |
| V2755 |
U-v lens, per lens |
59 |
29 |
$880.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
40 |
28 |
$700.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
20 |
20 |
$600.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
18 |
12 |
$360.00 |
| 92136 |
|
13 |
12 |
$201.03 |
| 76519 |
|
14 |
12 |
$195.40 |
| J2777 |
Injection, faricimab-svoa, 0.1 mg |
26 |
25 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
115 |
103 |
$0.00 |