| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Aflibercept injection |
17,024 |
15,740 |
$20.84M |
| 92004 |
|
59,500 |
58,306 |
$5.29M |
| 92014 |
|
73,549 |
71,429 |
$5.01M |
| 66984 |
|
12,707 |
11,271 |
$3.56M |
| 67028 |
|
38,356 |
35,778 |
$2.49M |
| 99214 |
|
27,899 |
26,264 |
$1.77M |
| 92134 |
|
45,125 |
42,455 |
$1.19M |
| 99213 |
|
24,718 |
23,008 |
$1.17M |
| J9035 |
Bevacizumab injection |
12,860 |
11,945 |
$777K |
| J2778 |
Ranibizumab injection |
995 |
954 |
$734K |
| J2777 |
Inj, faricimab-svoa, 0.1mg |
601 |
503 |
$576K |
| 92012 |
|
10,376 |
9,685 |
$554K |
| 67228 |
|
1,469 |
1,379 |
$422K |
| V2020 |
Vision svcs frames purchases |
18,827 |
18,689 |
$389K |
| 92015 |
|
85,923 |
84,036 |
$353K |
| 92136 |
|
11,291 |
10,513 |
$345K |
| 92340 |
|
10,353 |
10,317 |
$300K |
| V2784 |
Lens polycarb or equal |
16,196 |
11,919 |
$264K |
| 99204 |
|
1,454 |
1,388 |
$178K |
| 92083 |
|
2,946 |
2,655 |
$114K |
| 92133 |
|
4,197 |
3,882 |
$113K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
8,959 |
7,062 |
$104K |
| S9999 |
Sales tax |
3,578 |
3,184 |
$68K |
| V2100 |
Lens spher single plano 4.00 |
3,550 |
3,096 |
$63K |
| 92341 |
|
1,055 |
1,046 |
$35K |
| J0585 |
Injection,onabotulinumtoxina |
256 |
246 |
$28K |
| 92020 |
|
1,466 |
1,432 |
$23K |
| 64612 |
|
259 |
248 |
$23K |
| V2107 |
Spherocylinder 4.25d/12-2d |
929 |
732 |
$22K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,316 |
1,009 |
$19K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,998 |
1,642 |
$18K |
| 92025 |
|
695 |
690 |
$17K |
| V2200 |
Lens spher bifoc plano 4.00d |
510 |
477 |
$15K |
| 99203 |
|
141 |
139 |
$15K |
| 67113 |
|
12 |
12 |
$12K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
483 |
409 |
$11K |
| V2025 |
Eyeglasses delux frames |
403 |
400 |
$9K |
| 99212 |
|
255 |
239 |
$8K |
| 92002 |
|
115 |
115 |
$8K |
| J7999 |
Compounded drug, noc |
399 |
310 |
$6K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
202 |
176 |
$6K |
| 68761 |
|
50 |
40 |
$5K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
471 |
387 |
$5K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
148 |
116 |
$4K |
| 76512 |
|
64 |
51 |
$3K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
97 |
78 |
$2K |
| 66821 |
|
28 |
26 |
$2K |
| V2715 |
Prism lens/es |
247 |
181 |
$2K |
| V2744 |
Tint photochromatic lens/es |
147 |
145 |
$1K |
| V2101 |
Single visn sphere 4.12-7.00 |
127 |
107 |
$947.74 |
| 99215 |
Prolong outpt/office vis |
15 |
12 |
$870.98 |
| 76514 |
|
78 |
77 |
$576.76 |
| 92081 |
|
27 |
24 |
$543.15 |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
37 |
37 |
$471.48 |
| V2113 |
Spherocylindr 7.25d/4.25-6d |
12 |
12 |
$323.83 |
| V2299 |
Lens bifocal speciality |
14 |
14 |
$75.40 |
| 2022F |
|
2,661 |
2,631 |
$0.00 |
| V2750 |
Anti-reflective coating |
54 |
54 |
$0.00 |
| 2023F |
|
297 |
297 |
$0.00 |
| 3072F |
|
189 |
188 |
$0.00 |
| V2781 |
Progressive lens per lens |
14 |
14 |
$0.00 |