| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,166 |
5,046 |
$199K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,308 |
3,140 |
$110K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,428 |
1,009 |
$84K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,455 |
1,437 |
$67K |
| V2199 |
Not otherwise classified, single vision lens |
2,328 |
830 |
$62K |
| V2020 |
Frames, purchases |
3,799 |
3,120 |
$60K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,587 |
795 |
$57K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
130 |
92 |
$55K |
| 92134 |
|
1,926 |
1,818 |
$41K |
| J0178 |
Injection, aflibercept, 1 mg |
138 |
108 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
376 |
315 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,949 |
1,041 |
$21K |
| 92250 |
|
452 |
439 |
$19K |
| J9035 |
Injection, bevacizumab, 10 mg |
296 |
230 |
$4K |
| 92002 |
|
101 |
101 |
$4K |
| 92133 |
|
131 |
129 |
$4K |
| V2299 |
Specialty bifocal (by report) |
92 |
42 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
18 |
$2K |
| 92083 |
|
26 |
26 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
26 |
$1K |
| 92020 |
|
70 |
70 |
$973.49 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
23 |
13 |
$854.37 |
| 92060 |
|
20 |
20 |
$738.83 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
25 |
$609.50 |
| 92136 |
|
38 |
24 |
$410.33 |
| S0500 |
Disposable contact lens, per lens |
12 |
12 |
$265.00 |
| 76514 |
|
26 |
26 |
$208.78 |
| 92202 |
|
13 |
12 |
$105.23 |
| V2744 |
Tint, photochromatic, per lens |
167 |
96 |
$60.00 |
| V2750 |
Anti-reflective coating, per lens |
160 |
90 |
$0.00 |