| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97110 |
|
16,448 |
7,525 |
$347K |
| 97140 |
|
16,454 |
7,536 |
$318K |
| 97112 |
|
12,705 |
5,911 |
$311K |
| 99213 |
|
3,408 |
3,196 |
$215K |
| 97032 |
|
15,597 |
7,152 |
$164K |
| 92012 |
|
2,125 |
2,041 |
$161K |
| 92014 |
|
2,330 |
2,288 |
$141K |
| 97161 |
|
1,525 |
1,522 |
$94K |
| 97035 |
|
9,187 |
4,184 |
$87K |
| 99203 |
|
866 |
866 |
$83K |
| 92004 |
|
2,182 |
2,159 |
$77K |
| 92002 |
|
274 |
273 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,223 |
1,111 |
$18K |
| 99214 |
|
128 |
128 |
$12K |
| V2020 |
Frames, purchases |
2,358 |
2,355 |
$11K |
| 97162 |
|
161 |
161 |
$10K |
| 92226 |
|
333 |
197 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
881 |
440 |
$6K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
176 |
176 |
$4K |
| 92083 |
|
78 |
45 |
$4K |
| 92133 |
|
66 |
66 |
$2K |
| 92015 |
|
2,723 |
2,686 |
$2K |
| 99202 |
|
16 |
16 |
$1K |
| 92225 |
|
38 |
24 |
$899.72 |
| 92020 |
|
16 |
16 |
$357.70 |
| 76514 |
|
26 |
25 |
$197.03 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,322 |
1,158 |
$0.00 |
| 97124 |
|
92 |
42 |
$0.00 |
| V2755 |
U-v lens, per lens |
1,276 |
638 |
$0.00 |