| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological exa |
20,119 |
19,457 |
$828K |
| S0620 |
Routine ophthalmological exa |
14,988 |
14,569 |
$623K |
| 92014 |
|
11,290 |
11,061 |
$418K |
| 92004 |
|
4,369 |
4,296 |
$347K |
| 92340 |
|
7,336 |
7,312 |
$227K |
| 92012 |
|
7,289 |
6,636 |
$189K |
| V2020 |
Vision svcs frames purchases |
4,124 |
4,086 |
$95K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,243 |
1,186 |
$58K |
| 66984 |
|
845 |
775 |
$54K |
| 92015 |
|
4,611 |
4,526 |
$37K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,471 |
1,228 |
$29K |
| 92250 |
|
1,316 |
1,289 |
$20K |
| 99444 |
|
316 |
94 |
$18K |
| 92134 |
|
1,254 |
1,180 |
$16K |
| 67028 |
|
354 |
278 |
$15K |
| V2100 |
Lens spher single plano 4.00 |
536 |
490 |
$12K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
328 |
277 |
$6K |
| 92133 |
|
291 |
283 |
$4K |
| 92083 |
|
297 |
275 |
$4K |
| 76519 |
|
477 |
461 |
$4K |
| J9035 |
Bevacizumab injection |
48 |
41 |
$2K |
| 66821 |
|
56 |
49 |
$1K |
| 92136 |
|
60 |
60 |
$1K |
| V2107 |
Spherocylinder 4.25d/12-2d |
75 |
61 |
$930.30 |
| 99204 |
|
12 |
12 |
$926.24 |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
24 |
19 |
$585.94 |
| 92025 |
|
12 |
12 |
$351.75 |
| V2200 |
Lens spher bifoc plano 4.00d |
14 |
13 |
$301.58 |
| 76514 |
|
27 |
25 |
$236.38 |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
13 |
12 |
$162.94 |
| 2026F |
|
3,766 |
3,759 |
$0.00 |
| V2784 |
Lens polycarb or equal |
34 |
34 |
$0.00 |