| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
302,727 |
300,532 |
$8.60M |
| S0621 |
Routine ophthalmological exa |
131,529 |
131,341 |
$5.88M |
| S0620 |
Routine ophthalmological exa |
114,172 |
114,017 |
$4.97M |
| 92340 |
|
238,844 |
237,396 |
$4.67M |
| V2100 |
Lens spher single plano 4.00 |
179,278 |
177,880 |
$2.06M |
| 92341 |
|
53,224 |
53,015 |
$1.19M |
| V2784 |
Lens polycarb or equal |
68,149 |
67,218 |
$900K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
65,118 |
64,629 |
$738K |
| V2200 |
Lens spher bifoc plano 4.00d |
33,440 |
33,228 |
$514K |
| 92004 |
|
6,821 |
6,751 |
$329K |
| 92014 |
|
5,567 |
5,531 |
$274K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
19,418 |
19,382 |
$256K |
| V2300 |
Lens sphere trifocal 4.00d |
5,818 |
5,758 |
$126K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
9,447 |
9,345 |
$110K |
| 92310 |
|
4,159 |
4,133 |
$109K |
| V2107 |
Spherocylinder 4.25d/12-2d |
7,573 |
7,519 |
$86K |
| V2410 |
Lens variab asphericity sing |
1,954 |
1,941 |
$31K |
| V2744 |
Tint photochromatic lens/es |
5,280 |
5,224 |
$27K |
| 92015 |
|
1,809 |
1,809 |
$20K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
1,605 |
1,602 |
$17K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
1,271 |
1,265 |
$15K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
1,309 |
1,287 |
$15K |
| V2101 |
Single visn sphere 4.12-7.00 |
1,590 |
1,577 |
$14K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
1,695 |
1,685 |
$14K |
| V2781 |
Progressive lens per lens |
1,744 |
1,721 |
$13K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
975 |
973 |
$11K |
| 92250 |
|
353 |
353 |
$8K |
| V2745 |
Tint, any color/solid/grad |
906 |
898 |
$5K |
| 92342 |
|
158 |
158 |
$4K |
| V2755 |
Uv lens/es |
7,947 |
7,887 |
$3K |
| V2520 |
Contact lens hydrophilic |
41 |
34 |
$2K |
| 99214 |
|
27 |
27 |
$2K |
| 99204 |
|
15 |
15 |
$1K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
87 |
85 |
$794.13 |
| 99203 |
|
12 |
12 |
$693.12 |
| 99212 |
|
12 |
12 |
$362.10 |
| V2750 |
Anti-reflective coating |
10,488 |
10,391 |
$85.47 |
| V2799 |
Misc vision item or service |
952 |
937 |
$36.37 |
| V2025 |
Eyeglasses delux frames |
111 |
111 |
$19.80 |
| 2023F |
|
276 |
276 |
$0.00 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
1,281 |
1,270 |
$0.00 |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
40 |
39 |
$0.00 |
| 3072F |
|
64 |
64 |
$0.00 |
| 2000F |
|
91 |
84 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
12 |
12 |
$0.00 |
| S9986 |
Not medically necessary svc |
14 |
14 |
$0.00 |